Provider Demographics
NPI:1013040054
Name:SIMONE, QUIENDRA ROCHELLE (RDH)
Entity Type:Individual
Prefix:MRS
First Name:QUIENDRA
Middle Name:ROCHELLE
Last Name:SIMONE
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10617 ALEXANDRIA DR
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75035-7875
Mailing Address - Country:US
Mailing Address - Phone:972-377-3591
Mailing Address - Fax:469-635-1108
Practice Address - Street 1:1205 W MCDERMOTT DR
Practice Address - Street 2:
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75013-6305
Practice Address - Country:US
Practice Address - Phone:214-778-1900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12170124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist