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NPI Code Detail

MEDICARE: DR. AMANDA SIMONE ADAMS DDS

MEDICARE: DR. AMANDA SIMONE ADAMS DDS
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
1122300000XDentistDDS-10423IA
2122300000XDentistDN30947FL
3122300000XDentistDN123955GA

General Provider Information

NPI Number : 1780425843
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. AMANDA SIMONE ADAMS DDS
Provider Business Mailing Address
First Line : 6551 SW COUNTY ROAD 242
Second Line :
City : LAKE CITY
State : FL
Zip : 32024-4425
Country : US
Telephone Number : 386-965-3250
Fax Number :
Provider Business Practice Location Address
First Line : 1867 JONESBORO RD
Second Line :
City : MCDONOUGH
State : GA
Zip : 30253-6099
Country : US
Telephone Number : 678-432-0209
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/03/2024
Last Update Date : 03/23/2026

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Directions to “ DR. AMANDA SIMONE ADAMS DDS” Practice Location

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