Individual provider Active NPI

Denise Shiosaky, D.D.S.

  • Dentist
  • San Francisco, CA
National Provider Identifier
1629244835
Registry record updated Jan 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
55202 Issued in CA
Practice address
2482 Mission St
San Francisco, CA 94110-2415
Phone
(415) 660-5897
Fax
(415) 800-7559
NPI assigned
May 7, 2008
Last updated
Jan 11, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 55202 CA Primary

Addresses

Primary practice location

2482 Mission St
San Francisco, CA 94110-2415

Mailing address

2482 Mission St
San Francisco, CA 94110-2415
Phone (415) 660-5897

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
55202CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Yang DDS Inc PastSince Jan 14, 2024 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1210118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704931200000",
    "number": "1629244835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2482 MISSION ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941102415",
            "telephone_number": "415-660-5897",
            "fax_number": "415-800-7559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2482 MISSION ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941102415",
            "telephone_number": "415-660-5897",
            "fax_number": "415-800-7559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIOSAKY",
        "first_name": "DENISE",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-05-07",
        "last_updated": "2024-01-11",
        "certification_date": "2024-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "55202",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2024; 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.