Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Shima Phoenix, DMD

Individual provider Dentist · NPI 1588040976

Shima Phoenix, DMD is a Dentist in Mount Vernon, Illinois. Licensed in Illinois. Registered with an NPI since 2015.

Licensed in
IL
In the registry since
2015
What do these letters mean?
DMD — Doctor of Dental Medicine
A dentist. Identical training and licensing to a DDS.

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Practice location Address checks out

4201 Broadway St
Mount Vernon, IL 62864-2282
Phone: (618) 241-0997
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dentist (primary) Taxonomy 122300000X · Licence 019.030430 (IL)

Record details

NPI number1588040976
Entity typeIndividual (Type 1)
GenderFemale
Credentials DMD
Sole proprietorNo
NPI enumeratedAugust 7, 2015
Last updated in NPPESAugust 20, 2015
Mailing address4201 Broadway St, Mount Vernon, IL 62864-2282

Other providers in Mount Vernon