Individual provider Active NPI

Shivani Kamodia Barto, DDS

  • General Practice Dentistry
  • San Diego, CA
National Provider Identifier
1053805440
Registry record updated Jul 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
33944 Issued in TX
Practice address
1802 Cable St
San Diego, CA 92107-3103
Phone
(619) 223-3423
NPI assigned
Jun 19, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 28, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Customized Equipment (DME) 332BC3200X 33944 TX
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X 33944 TX Primary

Addresses

Primary practice location

1802 Cable St
San Diego, CA 92107-3103

Mailing address

4670 Newport Ave
San Diego, CA 92107-2944
Phone (607) 239-0910

Other practice location 1

6212 De Zavala Rd
San Antonio, TX 78249-2201
Phone (607) 239-0910

Other practice location 2

902 Kitty Hawk Rd Ste 100
Universal City, TX 78148-3962
Phone (210) 566-5599

Other practice location 3

9234 N Loop 1604 W Ste 121
San Antonio, TX 78249-2984
Phone (210) 681-1121

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
33944TXMDSpeech-Language Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Bandera Modern Dentistry, PC Multi-Specialty Past Accepting new patients
Michele Yamada,DDS, Inc Past Accepting new patients
Kitty Hawk Smiles Dentistry and Orthodontics, PC General Practice Past Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1529366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785196800000",
    "number": "1053805440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4670 NEWPORT AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921072944",
            "telephone_number": "607-239-0910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1802 CABLE ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921073103",
            "telephone_number": "619-223-3423"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6212 De Zavala Rd",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782492201",
            "country_code": "US",
            "telephone_number": "607-239-0910",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "902 Kitty Hawk Rd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Universal City",
            "state": "TX",
            "postal_code": "781483962",
            "country_code": "US",
            "telephone_number": "210-566-5599",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9234 N Loop 1604 W Ste 121",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782492984",
            "country_code": "US",
            "telephone_number": "210-681-1121",
            "fax_number": "210-681-1321",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BARTO",
        "first_name": "SHIVANI",
        "middle_name": "KAMODIA",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-06-19",
        "last_updated": "2026-07-28",
        "certification_date": "2026-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": "TX",
            "license": "33944",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "33944",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.