MEDICARE: DANIEL WILLIAM SIMS PROFESSIONAL CORPORATION

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	1223P0221X	Pediatric Dentistry	S6-19	NV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1003939810
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DANIEL WILLIAM SIMS PROFESSIONAL CORPORATION

Provider Business Mailing Address
First Line	:	375 N STEPHANIE ST BLDG 6
Second Line	:	SUITE 611
City	:	HENDERSON
State	:	NV
Zip	:	89014-8771
Country	:	US
Telephone Number	:	702-990-7336
Fax Number	:	702-990-7340

Provider Business Practice Location Address
First Line	:	375 N STEPHANIE ST BLDG 6
Second Line	:	SUITE 611
City	:	HENDERSON
State	:	NV
Zip	:	89014-8771
Country	:	US
Telephone Number	:	702-990-7336
Fax Number	:	702-990-7340

Authorized Official
Title or Position	:	CEO
Name	:	DR. DANIEL WILLIAM SIMS
Credential	:	D.D.S.
Telephone Number	:	702-990-7336

Provider Enumeration Date	:	04/08/2007
Last Update Date	:	09/12/2012

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