Active NPI
Craig R. Shimizu, D.D.S.
- General Practice Dentistry
- Lyndhurst, OH
National Provider Identifier
1629023643
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 17176
- Practice address
- 5682 Mayfield Rd
Lyndhurst, OH 44124-2916 - Phone
- (440) 449-9111
- Fax
- (440) 461-0007
- NPI assigned
- May 24, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 17176 | OH | Primary |
Addresses
Primary practice location
5682 Mayfield Rd
Lyndhurst, OH 44124-2916
Mailing address
5682 Mayfield Rd
Lyndhurst, OH 44124-2916
Phone (440) 449-9111
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
| License | State | Type | Specialty |
|---|---|---|---|
| 17176 | OH | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148428800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1629023643",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5682 MAYFIELD RD",
"city": "LYNDHURST",
"state": "OH",
"postal_code": "441242916",
"telephone_number": "440-449-9111",
"fax_number": "440-461-0007"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5682 MAYFIELD RD",
"city": "LYNDHURST",
"state": "OH",
"postal_code": "441242916",
"telephone_number": "440-449-9111",
"fax_number": "440-461-0007"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHIMIZU",
"first_name": "CRAIG",
"middle_name": "R.",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-24",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "OH",
"license": "17176",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lyndhurst, OH
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.