Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1588040976 Individual Practitioner Female Practitioner

Dr. Shima Phoenix , DMD

Dentist • Mount Vernon, IL

Professional Overview & Biography Verified Profile Summary

Dr. Shima Phoenix, DMD is a registered healthcare professional specializing in Dentist in Mount Vernon, IL. Practice services are available at 4201 BROADWAY ST under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

4201 Broadway St

Mount Vernon, IL 628642282

Telephone 6182410997
Associated Practice Facility / Clinic
🏢 Roy D. Bower, Dmd, Llc Facility NPI 1841682549

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist in Mount Vernon, IL

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 12.1 Yrs
Regional Practice Density
9 Specialists

Practicing in Mount Vernon, IL (4751 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Dentist Primary Specialty

NUCC Taxonomy Code: 122300000X

State License IL 019.030430

A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active August 20, 2015

NPI status registered as active in NPPES database

📍
Updated Practice Location August 20, 2015

Registered at 4201 BROADWAY ST, MOUNT VERNON, IL 628642282 (Tel: 6182410997)

📍
Updated Business Mailing Address August 20, 2015

Registered at 4201 BROADWAY ST, MOUNT VERNON, IL 628642282 (Tel: 6182410997)

👤
Provider Name / Credentials Updated August 20, 2015

Recorded as SHIMA PHOENIX, DMD

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) August 20, 2015

Dentist (License #019.030430 in IL)

🟢
Initial NPI Registration & Enumeration August 07, 2015

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1588040976
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: August 07, 2015
Last Update: August 20, 2015
Sole Proprietor: No

Mailing Address

4201 Broadway St

Mount Vernon, IL 628642282

Phone: 6182410997

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.