Provider Demographics
NPI:1326195389
Name:HILGER, SHILO JAMES (DDS)
Entity Type:Individual
Prefix:DR
First Name:SHILO
Middle Name:JAMES
Last Name:HILGER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:RICHLAND
Mailing Address - State:IA
Mailing Address - Zip Code:52585-9212
Mailing Address - Country:US
Mailing Address - Phone:319-456-4400
Mailing Address - Fax:
Practice Address - Street 1:100 W MAIN ST
Practice Address - Street 2:
Practice Address - City:RICHLAND
Practice Address - State:IA
Practice Address - Zip Code:52585-9212
Practice Address - Country:US
Practice Address - Phone:319-456-4400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-04
Last Update Date:2016-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA086921223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN5440220Medicaid