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General NPI Number Information
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NPI Number | 1134567811
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Entity Type | Individual
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Provider Name | OR SIMEL DDS, MD
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Gender | Male
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Dates
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Enumeration Date | 06/04/2013
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Last Update Date | 03/24/2024
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Provider Practice Location Address
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Address Line | 990 W FREMONT AVE STE J
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City | SUNNYVALE
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State | CA
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Zip | 94087-3065
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Country | US
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Telephone | 408-431-1782
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Fax |
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Provider Business Mailing Address
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Address Line | 1303 5TH AVE
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City | SAN FRANCISCO
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State | CA
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Zip | 94122-2618
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Country | US
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Telephone | 408-431-1782
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 63216
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License Number State | CA
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