Individual provider Active NPI

Steven James Shimamoto, D.M.D

  • General Practice Dentistry
  • Billings, MT
National Provider Identifier
1194923334
Registry record updated Jun 10, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2245 Issued in MT
Practice address
2370 Ave C
Suite 3
Billings, MT 59102
Phone
(406) 652-2130
Fax
(406) 652-7764
NPI assigned
Jul 10, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 10, 2013

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health Dentistry 1223D0001X 2245 MT
Dentist 122300000X 2245 MT
General Practice Dentistry 1223G0001X 2245 MT Primary

Addresses

Primary practice location

2370 Ave C
Suite 3
Billings, MT 59102

Mailing address

2370 Ave C
Suite 3
Billings, MT 59102
Phone (406) 652-2130

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150820012058 MT Order and Referring Only - DentistPractitioner - Dentist 7214242171

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2245MTMDPublic Health Dentist

NPI Registry JSON

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

{
    "created_epoch": "1184025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370822400000",
    "number": "1194923334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2370 AVE C",
            "address_2": "SUITE 3",
            "city": "BILLINGS",
            "state": "MT",
            "postal_code": "59102",
            "telephone_number": "406-652-2130",
            "fax_number": "406-652-7764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2370 AVE C",
            "address_2": "SUITE 3",
            "city": "BILLINGS",
            "state": "MT",
            "postal_code": "59102",
            "telephone_number": "406-652-2130",
            "fax_number": "406-652-7764"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIMAMOTO",
        "first_name": "STEVEN",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "D.M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-07-10",
        "last_updated": "2013-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223D0001X",
            "taxonomy_group": "",
            "desc": "Dentist, Dental Public Health",
            "state": "MT",
            "license": "2245",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MT",
            "license": "2245",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MT",
            "license": "2245",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Billings, MT

Sources for this page

Verify at the official NPI Registry.