Healthcare Provider Details

I. General information

NPI: 1578734182
Provider Name (Legal Business Name): ANNE FITZGERALD SIMONSEN D.M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2008
Last Update Date: 07/09/2024
Certification Date: 07/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26335 CARMEL RANCHO BLVD STE 5
CARMEL CA
93923-8889
US

IV. Provider business mailing address

26335 CARMEL RANCHO BLVD STE 5
CARMEL CA
93923-8889
US

V. Phone/Fax

Practice location:
  • Phone: 831-622-7100
  • Fax: 831-293-8643
Mailing address:
  • Phone: 831-622-7100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDDS62302
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: