Shih Fang Cheng, DMD
Individual provider Active NPI Dentist · Litchfield, IL
NPI 1356475875 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1356475875
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- Practice address
- 620 W Union Ave
Litchfield, IL 62056-1061 - Phone
- (217) 324-3431
- Fax
- (217) 324-3414
- NPI assigned
- Mar 15, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 019026218 | IL | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dental Professionals of Illinois, P.C. | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | IL | Yes |
Addresses
Primary practice location
620 W Union Ave
Litchfield, IL 62056-1061
Mailing address
620 W Union Ave
Litchfield, IL 62056-1061
Phone (217) 324-3431
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1005628 | Medicaid | IL |
Other providers in Litchfield, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.