Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jimmy Shak

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1285132530

Jimmy Shak is a Student in an Organized Health Care Education/Training Program in Old Bridge, New Jersey. Practices as a sole proprietor. Licensed in New Jersey.

Licensed in
NJ
In the registry since
2018
Specialties on file
2

Practice location Address checks out

Student / training record This NPI belongs to someone enrolled in a health care training programme. It carries no licence and no practice of its own, so no address or phone number is published for it.

Old Bridge, NJ

Specialties & licences

Pediatric Dentistry (primary) Taxonomy 1223P0221X · Licence 22DI02796200 (NJ)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1285132530
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedJanuary 31, 2018
Last updated in NPPESMay 17, 2021
Certification dateApril 27, 2021

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