Dr. Kelly Alexandra Shimada, D.D.S.
Dentist, Prosthodontics in Los Angeles, CA. Individual provider (NPI-1).
NPI number1184075111
StatusActive
Last updated in NPPESMar 27, 2020
Details
- NPI
- 1184075111
- Entity type
- Individual (NPI-1)
- Name
- Dr. Kelly Alexandra Shimada
- Credential
- D.D.S.
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jun 30, 2016
- Certification date
- Mar 27, 2020
- Last updated
- Mar 27, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223P0700X | Dentist, Prosthodontics | 64313 | CA | Yes |
Practice location
11301 Wilshire BlvdBldg 500 Dental
Los Angeles, CA 90073-1003
Phone 626-399-5248
Mailing address
25078 Peachland Ave Ste HNewhall, CA 91321-2555
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