Fumio Shibata, DDS

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

16047 Issued in CA

Practice address

2200 Larkspur Landing Circle
Suite 103
Larkspur, CA 94939

Phone

(415) 608-7823

NPI assigned

Mar 6, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Fumio Shibata DDS a Professional Corp

  • Periodontics
  • Larkspur, CA
  • NPI 1447380928
  NPD (past) Authorized official

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

{
    "created_epoch": "1173139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1730219106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4447",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949134447",
            "telephone_number": "415-608-7823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 LARKSPUR LANDING CIRCLE",
            "address_2": "SUITE 103",
            "city": "LARKSPUR",
            "state": "CA",
            "postal_code": "94939",
            "telephone_number": "415-608-7823"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIBATA",
        "first_name": "FUMIO",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "CA",
            "license": "16047",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicole Taylor See, PA
• Michele Senbertrand, NP
• Akash Shah, MD
• Sara Shaw, RN, IBCLC
• Ines Sherifi, M.D.
• Jamal Shillingford
• Donna Lee Shoemaker, CN
• Shoreline Lactation LLC (Shoreline Lactation)
• Anne Purdy Sillcocks, IBCLC
• Teresa Lynn Simi, NP, RN

• Periodontics in Larkspur, CA
• Providers in Larkspur, CA by specialty
• Periodontics in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.