Provider Demographics
NPI:1689747834
Name:SHIH, JENG-KANG RICHARD (DDS)
Entity Type:Individual
Prefix:DR
First Name:JENG-KANG
Middle Name:RICHARD
Last Name:SHIH
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:JENG-KANG
Other - Middle Name:RICHARD
Other - Last Name:SHIH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
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:858-863-5906
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
Is Sole Proprietor?:No
Enumeration Date:2006-11-16
Last Update Date:2023-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA40885122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist