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NPI Code Detail

MEDICARE: DR. MICHAEL J SIMS D.M.D. PC

MEDICARE: DR. MICHAEL J SIMS D.M.D. PC
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
1122300000XDentist0401006482VA

General Provider Information

NPI Number : 1861671638
Entity Type Code : Organization
Provider Name (Legal Business Name) : DR. MICHAEL J SIMS D.M.D. PC
Provider Business Mailing Address
First Line : 2109 MCCOMAS WAY
Second Line : ST 101
City : VIRGINIA BEACH
State : VA
Zip : 23456-3909
Country : US
Telephone Number : 757-427-0695
Fax Number : 757-430-9341
Provider Business Practice Location Address
First Line : 2109 MCCOMAS WAY
Second Line : ST 101
City : VIRGINIA BEACH
State : VA
Zip : 23456-3909
Country : US
Telephone Number : 757-427-0695
Fax Number : 757-430-9341
Authorized Official
Title or Position : DENTIST
Name : DR. MICHAEL JOESPH SIMS
Credential : D.M.D.
Telephone Number : 757-427-0695
Provider Enumeration Date : 10/30/2007
Last Update Date : 10/30/2007

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