Provider Demographics
NPI:1568597540
Name:SHIH & OLSEN GP
Entity Type:Organization
Organization Name:SHIH & OLSEN GP
Other - Org Name:PENINSULA ENDODONTICS DENTAL GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICER MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAVEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:650-361-0180
Mailing Address - Street 1:3351 EL CAMINO REAL STE. 222
Mailing Address - Street 2:
Mailing Address - City:ATHERTON
Mailing Address - State:CA
Mailing Address - Zip Code:94027
Mailing Address - Country:US
Mailing Address - Phone:650-361-0180
Mailing Address - Fax:650-361-0113
Practice Address - Street 1:3351 EL CAMINO REAL STE. 222
Practice Address - Street 2:
Practice Address - City:ATHERTON
Practice Address - State:CA
Practice Address - Zip Code:94027
Practice Address - Country:US
Practice Address - Phone:650-361-0180
Practice Address - Fax:650-361-0113
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-22
Last Update Date:2022-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty