IndividualActive
Brian Shah, DDS, MD
NPI 1104867431 · Oral and Maxillofacial Surgery (Dentist) · St. Petersburg, FL
Provider details
- NPI number
- 1104867431
- Entity type
- Individual
- Primary specialty
- Oral and Maxillofacial Surgery (Dentist)Dental Providers
- Credential
- DDS, MD
- Sex
- Male
- Sole proprietor
- No
- License
- 019.028191 (IL)
Specialties & taxonomies
Dental Providers
Dental Providers
Allopathic & Osteopathic Physicians
Practice location
131 2nd Ave S
St. Petersburg, FL 33701-4382
Phone: (727) 823-3220
Fax: (727) 823-7284
Approximate (ZIP-level) locationGet directions
Mailing address
131 2nd Ave S
St. Petersburg, FL 33701-4382
Registry dates
- Enumerated
- 2006-06-09
- Last updated
- 2025-06-05
- Certified
- 2025-06-05
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.