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General NPI Number Information
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NPI Number | 1871227728
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Entity Type | Individual
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Provider Name | KATHRYN LAUREN SHIMIZU DDS
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Gender | Female
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Dates
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Enumeration Date | 07/14/2022
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Last Update Date | 06/11/2025
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Provider Practice Location Address
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Address Line | 8848 CALVINE RD STE 120
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City | SACRAMENTO
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State | CA
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Zip | 95828-9335
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Country | US
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Telephone | 916-307-6035
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Fax |
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Provider Business Mailing Address
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Address Line | 10182 CORNICE WAY
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City | ELK GROVE
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State | CA
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Zip | 95757-5012
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Country | US
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Telephone | 925-285-4025
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DDS108606
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License Number State | CA
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