Individual provider Active NPI

Shira Shasho, DMD

  • Dentist
  • San Diego, CA
National Provider Identifier
1538360797
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
58467 Issued in CA
Practice address
9225 Mira Mesa Blvd Ste 210
San Diego, CA 92126-4811
Phone
(858) 201-9483
NPI assigned
May 29, 2007
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 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 58467 CA
Dentist 122300000X 58467 CA Primary

Addresses

Primary practice location

9225 Mira Mesa Blvd Ste 210
San Diego, CA 92126-4811

Mailing address

11120 E Ocean Air Dr Ste 101-108
San Diego, CA 92130-4683
Phone (858) 201-9483

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
58467CAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1180396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1538360797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11120 E OCEAN AIR DR STE 101-108",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921304683",
            "telephone_number": "858-201-9483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9225 MIRA MESA BLVD STE 210",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921264811",
            "telephone_number": "858-201-9483"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHASHO",
        "first_name": "SHIRA",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-29",
        "last_updated": "2026-07-13",
        "certification_date": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": "CA",
            "license": "58467",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "58467",
            "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 13, 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.