Provider Demographics
NPI:1073650784
Name:SHIEH, ANDREW C (DDS)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:C
Last Name:SHIEH
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:CHANG
Other - Middle Name:EN
Other - Last Name:SHIEH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
Mailing Address - Street 1:1026 S 8TH AVE
Mailing Address - Street 2:
Mailing Address - City:ARCADIA
Mailing Address - State:CA
Mailing Address - Zip Code:91006-4403
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2563 ZOE AVE
Practice Address - Street 2:
Practice Address - City:HUNTINGTON PARK
Practice Address - State:CA
Practice Address - Zip Code:90255-4070
Practice Address - Country:US
Practice Address - Phone:323-588-6384
Practice Address - Fax:323-588-6385
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAB44084-011223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice