Provider Demographics
NPI:1336354737
Name:SHIMAZU, STEVEN (DDS)
Entity Type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:
Last Name:SHIMAZU
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:STEVE
Other - Middle Name:
Other - Last Name:SHIMWAZU
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:150 W FIRST STREET
Mailing Address - Street 2:SUITE 170
Mailing Address - City:CLAREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:91711
Mailing Address - Country:US
Mailing Address - Phone:909-625-6010
Mailing Address - Fax:909-625-2112
Practice Address - Street 1:150 W FIRST STREET
Practice Address - Street 2:SUITE 170
Practice Address - City:CLAREMONT
Practice Address - State:CA
Practice Address - Zip Code:91711
Practice Address - Country:US
Practice Address - Phone:909-625-6010
Practice Address - Fax:909-625-2112
Is Sole Proprietor?:No
Enumeration Date:2007-05-11
Last Update Date:2008-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA333721223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics