Healthcare Provider Details

I. General information

NPI: 1689700148
Provider Name (Legal Business Name): NANCY THERESA SIMONS DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/26/2007
Last Update Date: 09/12/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1780 S BELLAIRE ST SUITE 655
DENVER CO
80222-4307
US

IV. Provider business mailing address

1780 S BELLAIRE ST SUITE 655
DENVER CO
80222-4307
US

V. Phone/Fax

Practice location:
  • Phone: 303-758-0223
  • Fax:
Mailing address:
  • Phone: 303-758-0223
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number7077
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: