MEDICARE: DR. DON SIMKIN D.D.S.

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	1223G0001X	General Practice Dentistry	30263	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	030263	OTHER	NY	STATE LICENSE
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1639207376
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DON SIMKIN D.D.S.

Provider Business Mailing Address
First Line	:	PO BOX 1400
Second Line	:	62 MAIN STREET
City	:	LIVINGSTON MANOR
State	:	NY
Zip	:	12758-1400
Country	:	US
Telephone Number	:	845-439-4100
Fax Number	:

Provider Business Practice Location Address
First Line	:	62 MAIN ST.
Second Line	:
City	:	LIVINGSTON MANOR
State	:	NY
Zip	:	12758-1400
Country	:	US
Telephone Number	:	845-439-4100
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/02/2007
Last Update Date	:	07/08/2007

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