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NPI Code Detail

MEDICARE: JAMES K. SIMONS, D.D.S. AND ASSOCIATES

MEDICARE: JAMES K. SIMONS, D.D.S. AND ASSOCIATES
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223P0221XPediatric Dentistry9122TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2G60054OTHERTXCHIP GROUP IDENTIFIER
30013142OTHERTXFORTIS FACILITY IDENTIFIE

General Provider Information

NPI Number : 1376619502
Entity Type Code : Organization
Provider Name (Legal Business Name) : JAMES K. SIMONS, D.D.S. AND ASSOCIATES
Provider Business Mailing Address
First Line : 2700 S 1ST ST
Second Line :
City : AUSTIN
State : TX
Zip : 78704-5421
Country : US
Telephone Number : 512-442-4338
Fax Number : 512-442-6074
Provider Business Practice Location Address
First Line : 2700 S 1ST ST
Second Line :
City : AUSTIN
State : TX
Zip : 78704-5421
Country : US
Telephone Number : 512-442-4338
Fax Number : 512-442-6074
Authorized Official
Title or Position : OWNER
Name : JAMES KIRK SIMONS
Credential : D.D.S.
Telephone Number : 512-442-4338
Provider Enumeration Date : 11/28/2006
Last Update Date : 04/01/2010

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