MEDICARE: J. RICHARD SHIH, DDS. INC.

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	251B00000X	Case Management Agency	40885	CA

General Provider Information

NPI Number	:	1407280217
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	J. RICHARD SHIH, DDS. INC.

Provider Business Mailing Address
First Line	:	PO BOX 675846
Second Line	:
City	:	RANCHO SANTA FE
State	:	CA
Zip	:	92067-5846
Country	:	US
Telephone Number	:	858-689-6088
Fax Number	:

Provider Business Practice Location Address
First Line	:	8226 MIRAMAR RD
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92126-4345
Country	:	US
Telephone Number	:	858-689-6088
Fax Number	:	858-689-6086

Authorized Official
Title or Position	:	DENTIST
Name	:	DR. JENG-KANG RICHARD SHIH
Credential	:	D.D.S
Telephone Number	:	858-689-6088

Provider Enumeration Date	:	08/28/2013
Last Update Date	:	10/06/2023

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