Provider Demographics
NPI:1194923334
Name:SHIMAMOTO, STEVEN JAMES (DMD)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:JAMES
Last Name:SHIMAMOTO
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2370 AVE C
Mailing Address - Street 2:SUITE 3
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59102
Mailing Address - Country:US
Mailing Address - Phone:406-652-2130
Mailing Address - Fax:406-652-7764
Practice Address - Street 1:2370 AVE C
Practice Address - Street 2:SUITE 3
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59102
Practice Address - Country:US
Practice Address - Phone:406-652-2130
Practice Address - Fax:406-652-7764
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-10
Last Update Date:2013-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT22451223D0001X, 122300000X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No1223D0001XDental ProvidersDentistDental Public Health
No122300000XDental ProvidersDentist