Individual provider Active NPI

Matthew Hunter Shinto, DDS

  • Dentist
  • Pasadena, CA
National Provider Identifier
1083283386
Registry record updated Jan 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
108509 Issued in CA
Practice address
301 S Fair Oaks Ave Ste 205
Pasadena, CA 91105-2536
Phone
(626) 796-8904
Fax
(626) 796-8998
NPI assigned
Jun 21, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 18, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 108509 CA Primary

Addresses

Primary practice location

301 S Fair Oaks Ave Ste 205
Pasadena, CA 91105-2536

Mailing address

7552 Black Star LN
La Palma, CA 90623-1415
Phone (562) 924-6811

Other practice location 1

26001 Redlands Blvd
Redlands, CA 92373-7762
Phone (909) 825-7084

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
108509CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Shinto and Kato General Dentistry CurrentSince Dec 3, 2023 Accepting new patients
Paul P. Shinto, D.D.S., Inc. PastSince Jan 22, 2023 Accepting new patients

Locations

301 S Fair Oaks Ave
Ste 205
Pasadena, CA 91105
Phone (626) 796-8904

Organizations & group practices 2

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": "1624233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674000000000",
    "number": "1083283386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7552 BLACK STAR LN",
            "city": "LA PALMA",
            "state": "CA",
            "postal_code": "906231415",
            "telephone_number": "562-924-6811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 S FAIR OAKS AVE STE 205",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911052536",
            "telephone_number": "626-796-8904",
            "fax_number": "626-796-8998"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "26001 Redlands Blvd",
            "address_purpose": "LOCATION",
            "city": "Redlands",
            "state": "CA",
            "postal_code": "923737762",
            "country_code": "US",
            "telephone_number": "909-825-7084",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHINTO",
        "first_name": "MATTHEW",
        "middle_name": "HUNTER",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-06-21",
        "last_updated": "2023-01-18",
        "certification_date": "2022-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "108509",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pasadena, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2023; 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.