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Active NPI 1477122919 Individual Practitioner Female Practitioner

Dr. Dhara Shah , DMD

Dentist - General Practice • Springfield, IL

Professional Overview & Biography Verified Profile Summary

Dr. Dhara Shah, DMD is a registered healthcare professional specializing in Dentist - General Practice in Springfield, IL. Practice services are available at 520 N 4TH ST under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

520 N 4th St

Springfield, IL 627025238

Telephone 2175458000
Fax 2177578161
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Springfield, IL

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 1.5 Yrs
State Avg: 18.0 Yrs
Regional Practice Density
77 Specialists

Practicing in Springfield, IL (5581 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2023-08-23
Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License IL 019.034239

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

Dentist

NUCC Taxonomy Code: 122300000X

State License IL 019.034239

A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.

Dentist - General Practice

NUCC Taxonomy Code: 1223G0001X

State License MI 2901600908

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

Secondary Practice Locations

3886 S Dequindre Rd Ste 105

Troy, MI 48083

Phone: 2488797755

109 3rd St

Lincoln, IL 626562604

Phone: 2177352317

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners
Amanda Henson , LCSW

Social Worker - Clinical

NPI 1003247115

Licensed Clinical Social Worker

Dr. Fadel Bofarrag , MD, MPH

Internal Medicine - Cardiovascular Disease

NPI 1003291279

Doctor of Medicine (M.D.), Master of Public Health

Jerry Priddy , PA-C

Physician Assistant

NPI 1003351115

Physician Assistant (Certified)

Dr. Ashley Mohan , DO

Internal Medicine - Hematology & Oncology

NPI 1003377565

Doctor of Osteopathic Medicine (D.O.)

Dr. Linda Ponce Rosas , MD

Internal Medicine - Endocrinology, Diabetes & Metabolism

NPI 1003501065

Doctor of Medicine (M.D.)

Jay Benoit

Nurse Practitioner - Family

NPI 1003579335

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

16 Historical Events
📍
Updated Practice Location August 23, 2023

Registered at 520 N 4TH ST, SPRINGFIELD, IL 627025238 (Tel: 2175458000)

📍
Updated Business Mailing Address August 23, 2023

Registered at PO BOX 19639, SPRINGFIELD, IL 627949639 (Tel: 2175458000)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) August 23, 2023

Dentist (License #019.034239 in IL)

📍
Updated Business Mailing Address November 22, 2022

Registered at 1854 WINDWOOD APT 204, ROCHESTER HILLS, MI 483075678 (Tel: 9737105354)

👤
Provider Name / Credentials Updated November 22, 2022

Recorded as DHARA SHAH, DMD

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) November 22, 2022

Dentist (License #2901600908 in MI)

📍
Updated Practice Location March 08, 2022

Registered at 3886 S DEQUINDRE RD STE 105, TROY, MI 48083 (Tel: 2488797755)

📍
Updated Business Mailing Address March 08, 2022

Registered at 3886 S DEQUINDRE RD STE 105, TROY, MI 48083 (Tel: 2488797755)

👤
Provider Name / Credentials Updated March 08, 2022

Recorded as DHARA SHAH, DDS

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) March 08, 2022

Dentist (License #21159140622 in MI)

NPI Profile Active June 19, 2021

NPI status registered as active in NPPES database

📍
Updated Practice Location June 19, 2021

Registered at 1854 WINDWOOD, ROCHESTER HILLS, MI 483075678 (Tel: 9737105354)

📍
Updated Business Mailing Address June 19, 2021

Registered at 1854 WINDWOOD APT 204, ROCHESTER HILLS, MI 483075678

👤
Provider Name / Credentials Updated June 19, 2021

Recorded as DHARA SHAH

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) June 19, 2021

Dentist (License #2901600908 in MI)

🟢
Initial NPI Registration & Enumeration June 19, 2021

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1477122919
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: June 19, 2021
Last Update: August 23, 2023
Sole Proprietor: Yes

Mailing Address

Po Box 19639

Springfield, IL 627949639

Phone: 2175458000

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.