Stason K. Shishido, D.D.S. Inc.

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

35551 Issued in CA

Legal business name

STASON K. SHISHIDO, D.D.S. INC.

Practice address

2025 Forest Ave Ste 3
San Jose, CA 95128-4806

Phone

(408) 294-6624

Fax

(408) 920-0937

NPI assigned

Mar 17, 2016

Organization subpart

No

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

Authorized official

Name

Dr. Stason Katsuro Shishido, D.D.S.NPI 1841339363

Title

President/Owner

Phone

(408) 294-6624

Specialties & licenses 1

Addresses

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Stason K. Shishido, D.D.S

  • General Practice Dentistry
  • San Jose, CA
  • NPI 1841339363
  NPD (past) Authorized official
• Hernan Cardenas, D.D.S.

  • Dentist
  • San Jose, CA
  • NPI 1477782555
  NPD (past)
• Nancy Bich Van Nguyen, D.D.S.

  • Dentist
  • San Jose, CA
  • NPI 1225316078
  NPD (past)
• Eugene P Ravizza, D.D.S.

  • Dentist
  • San Jose, CA
  • NPI 1356596183
  NPD (past)

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

{
    "created_epoch": "1458172800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1458172800000",
    "number": "1609237759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2025 FOREST AVE STE 3",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951284806",
            "telephone_number": "408-294-6624",
            "fax_number": "408-920-0937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2025 FOREST AVE STE 3",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951284806",
            "telephone_number": "408-294-6624",
            "fax_number": "408-920-0937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STASON K. SHISHIDO, D.D.S. INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-17",
        "last_updated": "2016-03-17",
        "status": "A",
        "authorized_official_last_name": "SHISHIDO",
        "authorized_official_first_name": "STASON",
        "authorized_official_middle_name": "KATSURO",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "408-294-6624",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "CA",
            "license": "35551",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ethan Starr
• Vanessa Starr, M.D.
• Richard W Starrett, MD
• Stephanie Ann Starritt
• Janet Elaine Stashak, MA, MFT
• State of California - Department of Developmental Services
• State of the Heart Wellness
• Audrey Danielle Staton
• Rhonda Staton
• Joanna U Staunton, MD

• Dental Clinic/Center in San Jose, CA
• Providers in San Jose, CA by specialty
• Dental Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 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.