Individual provider Active NPI

Gerald T Shinkawa, DDS

  • Dentist
  • Fresno, CA
National Provider Identifier
1346362472
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
26291 Issued in CA
Practice address
2948 N Fresno St
Fresno, CA 93703
Phone
(559) 226-5656
Fax
(559) 226-5672
NPI assigned
Apr 6, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 26291 CA Primary

Addresses

Primary practice location

2948 N Fresno St
Fresno, CA 93703

Mailing address

2948 N Fresno St
Fresno, CA 93703
Phone (559) 226-5656

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20160506001412 CA Order and Referring Only - DentistPractitioner - Dentist 9830498237

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
26291CAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1175817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1346362472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2948 N FRESNO ST",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "93703",
            "telephone_number": "559-226-5656",
            "fax_number": "559-226-5672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2948 N FRESNO ST",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "93703",
            "telephone_number": "559-226-5656",
            "fax_number": "559-226-5672"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHINKAWA",
        "first_name": "GERALD",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "26291",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

Verify at the official NPI Registry.