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Provider Information for 1669503397

Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know

KOSHA SHAH D.D.S.

Gender: FEMALE

Individual NPI: 1669503397

Calendar   Last Updated:  2007-07-08
  Certification Date: 

Details

Name Value
NPI 1669503397
Enumeration Date 2007-03-07
NPI Type 1 - Individual
Sole Proprietor NO
Status Active
Mailing Address 521 W CHANNEL ISLANDS BLVD STE 8
PORT HUENEME, CA 93041-2132
United States

Phone: 805-815-4356 | Fax:
View Map External Link
Primary Practice Address 521 W CHANNEL ISLANDS BLVD STE 8
PORT HUENEME, CA 93041-2132
United States

Phone: 805-815-4356 | Fax:
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
Other DENTI-CAL CA D49804
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 122300000X - Dentist CA 49804