Provider Demographics
NPI:1154674588
Name:SIMONIS, LUKE ANTHONY (DDS)
Entity Type:Individual
Prefix:DR
First Name:LUKE
Middle Name:ANTHONY
Last Name:SIMONIS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2780 W HORIZON RIDGE PKWY, STE 20
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89052-3995
Mailing Address - Country:US
Mailing Address - Phone:702-719-4700
Mailing Address - Fax:702-719-4701
Practice Address - Street 1:2780 W HORIZON RIDGE PKWY, STE 20
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89052-3995
Practice Address - Country:US
Practice Address - Phone:702-719-4700
Practice Address - Fax:702-719-4701
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-23
Last Update Date:2015-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV6323122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist