Provider Demographics
NPI:1164479267
Name:SIMKINS, BOYD WAYNE (DDS)
Entity Type:Individual
Prefix:DR
First Name:BOYD
Middle Name:WAYNE
Last Name:SIMKINS
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 1:2667 N WASHINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:NORTH OGDEN
Mailing Address - State:UT
Mailing Address - Zip Code:84414-2240
Mailing Address - Country:US
Mailing Address - Phone:801-782-3920
Mailing Address - Fax:801-782-4380
Practice Address - Street 1:2667 N WASHINGTON BLVD
Practice Address - Street 2:
Practice Address - City:NORTH OGDEN
Practice Address - State:UT
Practice Address - Zip Code:84414-2240
Practice Address - Country:US
Practice Address - Phone:801-782-3920
Practice Address - Fax:801-782-4380
Is Sole Proprietor?:No
Enumeration Date:2006-05-27
Last Update Date:2023-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT56370491223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT5637049OtherSTATE ID NUMBER
UT1692204OtherTRICARE PROVIDER NUMBER
UT56370499902001OtherBCBS PROVIDER NUMBER