Shima Phoenix, DMD
Dentist · Mount Vernon, IL
Practice location
4201 Broadway StMount Vernon, IL 62864-2282
- Phone
- (618) 241-0997
NPI record
- NPI
- 1588040976
- Entity type
- Individual (Type 1)
- Enumeration date
- August 7, 2015
- Last updated
- August 20, 2015
- Sole proprietor
- No
Specialties & taxonomy codes
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dentist Primary | 122300000X |
019.030430 | IL |
About Dr. Phoenix
Shima Phoenix, DMD is a healthcare provider registered in the NPI registry with the primary taxonomy Dentist (code 122300000X). The practice location is 4201 Broadway St, Mount Vernon, IL 62864-2282. The NPI number 1588040976 was assigned on August 7, 2015 and the record was last updated on August 20, 2015.
Dr. Phoenix lists a license in the registry: #019.030430 (IL) for Dentist. License numbers are self-reported to NPPES; verify them with the state licensing board.
Frequently asked questions
What is the NPI number of Shima Phoenix, DMD?
The NPI number is 1588040976.
What is the phone number of Dr. Phoenix?
The phone number listed for the practice location is (618) 241-0997.
Where is Dr. Phoenix located?
4201 Broadway St, Mount Vernon, IL 62864-2282.
What is the taxonomy code for Dr. Phoenix?
The primary taxonomy code is 122300000X – Dentist.
Is this information correct?
All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.
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