Chiyo Shidara D.D.S., Apc

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

48997 Issued in CA

Legal business name

CHIYO SHIDARA D.D.S., APC

Practice address

2150 Appian Way Ste 208
Pinole, CA 94564-2520

Phone

(510) 741-7100

Fax

(510) 741-7335

NPI assigned

Feb 18, 2016

Last updated

Feb 18, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Chiyo Shidara, D.D.S.

Title

President

Phone

(510) 741-7100

Specialties & licenses 1

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Carol Taylor Rose, RDH

  • Dental Hygienist
  • Pinole, CA
  • NPI 1467661827
  NPD (past)
• Douglas James Gordon, DDS

  • Dentist
  • Auburn, WA
  • NPI 1457363707
  NPD (past)

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

{
    "created_epoch": "1455753600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1455753600000",
    "number": "1568821635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "605 RIDGEVIEW DR",
            "city": "PLEASANT HILL",
            "state": "CA",
            "postal_code": "945231078",
            "telephone_number": "415-699-5554",
            "fax_number": "925-822-3965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2150 APPIAN WAY STE 208",
            "city": "PINOLE",
            "state": "CA",
            "postal_code": "945642520",
            "telephone_number": "510-741-7100",
            "fax_number": "510-741-7335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHIYO SHIDARA D.D.S., APC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-18",
        "last_updated": "2016-02-18",
        "status": "A",
        "authorized_official_last_name": "SHIDARA",
        "authorized_official_first_name": "CHIYO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "510-741-7100",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "48997",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ezah Cheema, OD
• Jennifer Chen, LAC
• Joann Cheung, PHARMD
• Chhina Dental Group (Pinole Family Dental)
• Chiral Mind Psychiatry a Professional Nursing Corporation
• Emily Choh
• Christine Choi
• Young Choi, O.D.
• Leslie C. Chow, D.M.D.
• Morgan Christiansen, PT, DPT

• General Practice Dentistry in Pinole, CA
• Providers in Pinole, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2016; 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.