Provider Demographics
NPI:1083283386
Name:SHINTO, MATTHEW HUNTER (DDS)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:HUNTER
Last Name:SHINTO
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7552 BLACK STAR LN
Mailing Address - Street 2:
Mailing Address - City:LA PALMA
Mailing Address - State:CA
Mailing Address - Zip Code:90623-1415
Mailing Address - Country:US
Mailing Address - Phone:562-924-6811
Mailing Address - Fax:
Practice Address - Street 1:301 S FAIR OAKS AVE STE 205
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91105-2536
Practice Address - Country:US
Practice Address - Phone:626-796-8904
Practice Address - Fax:626-796-8998
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-21
Last Update Date:2023-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA108509122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist