Provider Demographics
NPI:1437351418
Name:YEN SHIH, DDS, INC.
Entity Type:Organization
Organization Name:YEN SHIH, DDS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PUBLIC RELATIONS
Authorized Official - Prefix:MS
Authorized Official - First Name:VIKKY
Authorized Official - Middle Name:
Authorized Official - Last Name:FUNG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-812-6612
Mailing Address - Street 1:680 E ALOSTA AVE STE 108
Mailing Address - Street 2:
Mailing Address - City:AZUSA
Mailing Address - State:CA
Mailing Address - Zip Code:91702-2710
Mailing Address - Country:US
Mailing Address - Phone:626-812-6612
Mailing Address - Fax:626-812-6634
Practice Address - Street 1:680 E ALOSTA AVE STE 108
Practice Address - Street 2:
Practice Address - City:AZUSA
Practice Address - State:CA
Practice Address - Zip Code:91702-2710
Practice Address - Country:US
Practice Address - Phone:626-812-6612
Practice Address - Fax:626-812-6634
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA461371223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA46137OtherDENTISTRY