Provider Demographics
NPI:1407280217
Name:J. RICHARD SHIH, DDS. INC.
Entity Type:Organization
Organization Name:J. RICHARD SHIH, DDS. INC.
Other - Org Name:EZSMILE DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JENG-KANG
Authorized Official - Middle Name:RICHARD
Authorized Official - Last Name:SHIH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:858-689-6088
Mailing Address - Street 1:PO BOX 675846
Mailing Address - Street 2:
Mailing Address - City:RANCHO SANTA FE
Mailing Address - State:CA
Mailing Address - Zip Code:92067-5846
Mailing Address - Country:US
Mailing Address - Phone:858-689-6088
Mailing Address - Fax:
Practice Address - Street 1:8226 MIRAMAR RD
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92126-4345
Practice Address - Country:US
Practice Address - Phone:858-689-6088
Practice Address - Fax:858-689-6086
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-28
Last Update Date:2023-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA40885251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management