Kevin Shimizu, DDS, MSD

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

103587 Issued in CA

Practice address

877 W Fremont Ave Ste G1
Sunnyvale, CA 94087-2319

Phone

(408) 738-1314

NPI assigned

Oct 22, 2019

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

State licenses

Practice roles

Locations

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

• Shimizu Orthodontics

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Sunnyvale, CA
  • NPI 1255965729
  NPD Authorized official

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

{
    "created_epoch": "1571702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571702400000",
    "number": "1841833985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "877 W FREMONT AVE STE G1",
            "city": "SUNNYVALE",
            "state": "CA",
            "postal_code": "940872319",
            "telephone_number": "408-738-1314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "877 W FREMONT AVE STE G1",
            "city": "SUNNYVALE",
            "state": "CA",
            "postal_code": "940872319",
            "telephone_number": "408-738-1314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIMIZU",
        "first_name": "KEVIN",
        "name_prefix": "Dr.",
        "credential": "DDS, MSD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-10-22",
        "last_updated": "2019-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CA",
            "license": "103587",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shibani Rajadhyksha DDS Inc.
• Shield T3, LLC
• Karen Shih, M.D.
• Shimizu Orthodontics
• Kenneth Alan Shimizu, D.D.S., M.S.D.
• Warren Ken Shimotsu, DDS
• Haam-Baak Shin, RD
• Sandra Shin, D.M.D.
• Vyoma Shinde, OD
• Catherine Shir

• Orthodontics and Dentofacial Orthopedics Dentistry in Sunnyvale, CA
• Providers in Sunnyvale, CA by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2019; 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.