Healthcare Provider Details

I. General information

NPI: 1891035309
Provider Name (Legal Business Name): ALISON SIMPSON DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/20/2013
Last Update Date: 04/13/2021
Certification Date: 04/13/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

207 LINCOLN PARK RD
SPRINGFIELD KY
40069-1303
US

IV. Provider business mailing address

207 LINCOLN PARK RD
SPRINGFIELD KY
40069-1303
US

V. Phone/Fax

Practice location:
  • Phone: 859-336-3330
  • Fax: 859-336-3331
Mailing address:
  • Phone: 859-336-3330
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number9074
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: