MEDICARE: DR. SANDY THAI SHIH D.D.S.

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	54877	CA

General Provider Information

NPI Number	:	1831264167
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SANDY THAI SHIH D.D.S.

Provider Business Mailing Address
First Line	:	2401 OCEAN AVE
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94127-2606
Country	:	US
Telephone Number	:	415-334-0421
Fax Number	:

Provider Business Practice Location Address
First Line	:	2401 OCEAN AVE
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94127-2606
Country	:	US
Telephone Number	:	415-334-0421
Fax Number	:

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

Provider Enumeration Date	:	11/21/2006
Last Update Date	:	01/02/2015

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