Provider Demographics
NPI:1275786956
Name:SHIMA, DONALD (DDS)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:
Last Name:SHIMA
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 1:38 PIERMONT RD
Mailing Address - Street 2:
Mailing Address - City:TENAFLY
Mailing Address - State:NJ
Mailing Address - Zip Code:07670-1716
Mailing Address - Country:US
Mailing Address - Phone:201-569-8029
Mailing Address - Fax:210-569-8031
Practice Address - Street 1:38 PIERMONT RD
Practice Address - Street 2:
Practice Address - City:TENAFLY
Practice Address - State:NJ
Practice Address - Zip Code:07670-1716
Practice Address - Country:US
Practice Address - Phone:201-569-8029
Practice Address - Fax:210-569-8031
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-28
Last Update Date:2008-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI008332001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice