Individual provider Active NPI

Robert John Shima, D.D.S.

  • General Practice Dentistry
  • Temple City, CA
National Provider Identifier
1952522781
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
19255 Issued in CA
Practice address
9929 Las Tunas Dr.
Temple City, CA 91780-2211
Phone
(626) 285-4577
Fax
(626) 285-4577
NPI assigned
May 1, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 19255 CA Primary

Addresses

Primary practice location

9929 Las Tunas Dr.
Temple City, CA 91780-2211

Mailing address

9929 Las Tunas Dr.
Temple City, CA 91780-2211
Phone (626) 285-4577

Other identifiers 1

IdentifierTypeStateIssuer
19255OtherCASTATE DENTAL 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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
19255CAMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1177977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1952522781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9929 LAS TUNAS DR.",
            "city": "TEMPLE CITY",
            "state": "CA",
            "postal_code": "917802211",
            "telephone_number": "626-285-4577",
            "fax_number": "626-285-4577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9929 LAS TUNAS DR.",
            "city": "TEMPLE CITY",
            "state": "CA",
            "postal_code": "917802211",
            "telephone_number": "626-285-4577",
            "fax_number": "626-285-4577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIMA",
        "first_name": "ROBERT",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "19255",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE DENTAL LICENSE #",
            "identifier": "19255",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Temple City, CA

Sources for this page

  • 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.