Provider Demographics
NPI:1770834053
Name:GEORGE J. SHIA, D.D.S., INC.
Entity Type:Organization
Organization Name:GEORGE J. SHIA, D.D.S., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:SHIA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:512-454-2777
Mailing Address - Street 1:5527 SUNSHINE DR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78756-2223
Mailing Address - Country:US
Mailing Address - Phone:512-454-2777
Mailing Address - Fax:512-454-0140
Practice Address - Street 1:5527 SUNSHINE DR
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78756-2223
Practice Address - Country:US
Practice Address - Phone:512-454-2777
Practice Address - Fax:512-454-0140
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-26
Last Update Date:2012-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX61241223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty