Provider Demographics
NPI:1083003388
Name:YEN SHIU SHIH DDS PROF. INC.
Entity Type:Organization
Organization Name:YEN SHIU SHIH DDS PROF. INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:YEN
Authorized Official - Middle Name:SHIU
Authorized Official - Last Name:SHIH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:626-454-0865
Mailing Address - Street 1:2413 S GROVE AVE
Mailing Address - Street 2:
Mailing Address - City:ONTARIO
Mailing Address - State:CA
Mailing Address - Zip Code:91761-6225
Mailing Address - Country:US
Mailing Address - Phone:626-454-0865
Mailing Address - Fax:
Practice Address - Street 1:2413 S GROVE AVE
Practice Address - Street 2:
Practice Address - City:ONTARIO
Practice Address - State:CA
Practice Address - Zip Code:91761-6225
Practice Address - Country:US
Practice Address - Phone:626-454-0865
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-09
Last Update Date:2015-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA46137122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty