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General NPI Number Information
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NPI Number | 1801547302
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Entity Type | Individual
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Provider Name | SONYA RENEE SIMS RDH
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Gender | Female
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Dates
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Enumeration Date | 01/16/2022
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Last Update Date | 01/16/2022
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Provider Practice Location Address
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Address Line | 5612 BRAINERD RD STE 100
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City | CHATTANOOGA
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State | TN
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Zip | 37411-5310
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Country | US
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Telephone | 423-485-1000
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Fax | 423-485-1233
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Provider Business Mailing Address
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Address Line | 4226 GREEN SHANTY RD
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City | OOLTEWAH
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State | TN
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Zip | 37363-9024
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Country | US
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Telephone | 423-774-2225
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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 | 124Q00000X
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Taxonomy Name | Dental Hygienist
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License Number | 4467
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License Number State | TN
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