Provider Demographics
NPI:1962086397
Name:SHAH, PRIYA NAYANESH (DMD)
Entity type:Individual
Prefix:MISS
First Name:PRIYA
Middle Name:NAYANESH
Last Name:SHAH
Suffix:
Gender:
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43490 YUKON DR STE 105
Mailing Address - Street 2:
Mailing Address - City:ASHBURN
Mailing Address - State:VA
Mailing Address - Zip Code:20147-7303
Mailing Address - Country:US
Mailing Address - Phone:703-665-4955
Mailing Address - Fax:
Practice Address - Street 1:4910 MASSACHUSETTS AVE NW STE 311
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20016-4368
Practice Address - Country:US
Practice Address - Phone:202-237-2833
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-11
Last Update Date:2025-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014185741223P0221X
DCDEN20003191223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry