Healthcare Provider Details

I. General information

NPI: 1437239654
Provider Name (Legal Business Name): SURESH NARAIN SIMLOTE DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/16/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6320 E FLORENCE AVE STE G
BELL GARDENS CA
90201-4742
US

IV. Provider business mailing address

6320 E FLORENCE AVE STE G
BELL GARDENS CA
90201-4742
US

V. Phone/Fax

Practice location:
  • Phone: 562-927-2377
  • Fax: 562-927-2377
Mailing address:
  • Phone: 562-927-2377
  • Fax: 562-927-6008

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number48022
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: