MEDICARE: DR. SIMON SHIH DMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	4877	NV
2	1223G0001X	General Practice Dentistry	4877	NV

General Provider Information

NPI Number	:	1346383932
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SIMON SHIH DMD

Provider Business Mailing Address
First Line	:	7720 W SAHARA AVE STE 110
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-2754
Country	:	US
Telephone Number	:	702-242-4680
Fax Number	:	702-304-9996

Provider Business Practice Location Address
First Line	:	7720 W SAHARA AVE STE 110
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-2754
Country	:	US
Telephone Number	:	702-242-4680
Fax Number	:	702-304-9996

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/14/2007
Last Update Date	:	08/27/2014

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Directions to “ DR. SIMON SHIH DMD” Practice Location

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