Active NPI
Shivani Kamodia Barto, DDS
- General Practice Dentistry
- San Diego, CA
National Provider Identifier
1053805440
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 33944
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Customized Equipment (DME) | 332BC3200X | 33944 | TX | |
| General Practice Dentistry | 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
| License | State | Type | Specialty |
|---|---|---|---|
| 33944 | TX | MD | Speech-Language Assistant |
Practice roles
| Organization | Specialty | Status | New 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.
-
- Dentist
- San Diego, CA
- NPI 1083888499
-
- General Practice Dentistry
- Universal City, TX
- NPI 1245599539
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.