Individual provider Active NPI

Dean Shoji Kashino, M.D.

  • Family Medicine Physician
  • Santa Cruz, CA
National Provider Identifier
1811984446
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
G35500 Issued in CA
Practice address
1779 Dominican Way Ste B
Santa Cruz, CA 95065-1526
Phone
(831) 318-6010
Fax
(831) 479-4967
NPI assigned
Sep 29, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X G35500 CA Primary

Addresses

Primary practice location

1779 Dominican Way Ste B
Santa Cruz, CA 95065-1526

Mailing address

3400 Data Dr
Attn: Credentialing/Payer Enrollment
Rancho Cordova, CA 95670-7956

Other practice location 1

1595 Soquel Dr
Suite 411
Santa Cruz, CA 95065-1719
Phone (831) 475-8834

Other identifiers 2

IdentifierTypeStateIssuer
00G355000MedicaidCA
G035500OtherCACA MEDICAL LICENSE

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)
Enrolled
Credentials
Doctor of Medicine

NPI Registry JSON

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

{
    "created_epoch": "1127952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1811984446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 DATA DR",
            "address_2": "ATTN: CREDENTIALING/PAYER ENROLLMENT",
            "city": "RANCHO CORDOVA",
            "state": "CA",
            "postal_code": "956707956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1779 DOMINICAN WAY STE B",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950651526",
            "telephone_number": "831-318-6010",
            "fax_number": "831-479-4967"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1595 Soquel Dr",
            "address_2": "SUITE 411",
            "address_purpose": "LOCATION",
            "city": "Santa Cruz",
            "state": "CA",
            "postal_code": "950651719",
            "country_code": "US",
            "telephone_number": "831-475-8834",
            "fax_number": "831-475-0351",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KASHINO",
        "first_name": "DEAN",
        "middle_name": "SHOJI",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-29",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G35500",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G355000",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CA MEDICAL LICENSE",
            "identifier": "G035500",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Cruz, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.