MEDICARE: SSS ORTHODONTICS, LLC

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
1	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry

General Provider Information

NPI Number	:	1558224725
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SSS ORTHODONTICS, LLC

Provider Business Mailing Address
First Line	:	3731 CHAMBLEE DUNWOODY RD
Second Line	:
City	:	CHAMBLEE
State	:	GA
Zip	:	30341-2062
Country	:	US
Telephone Number	:	404-480-4940
Fax Number	:	404-480-9630

Provider Business Practice Location Address
First Line	:	3731 CHAMBLEE DUNWOODY RD
Second Line	:
City	:	CHAMBLEE
State	:	GA
Zip	:	30341-2062
Country	:	US
Telephone Number	:	404-480-4940
Fax Number	:	404-480-9630

Authorized Official
Title or Position	:	OWNER/PRESIDENT
Name	:	DR. YAHAZIEL SIMON
Credential	:	DMD, MSD
Telephone Number	:	404-480-4940

Provider Enumeration Date	:	12/04/2025
Last Update Date	:	12/04/2025

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Directions to “SSS ORTHODONTICS, LLC ” Practice Location

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