Provider Demographics
NPI:1265661367
Name:SIMPSON, RICHARD ANDREW (DDS)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:ANDREW
Last Name:SIMPSON
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 1:9220 ELLERBE RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71106-6739
Mailing Address - Country:US
Mailing Address - Phone:318-868-0830
Mailing Address - Fax:318-868-7260
Practice Address - Street 1:9220 ELLERBE RD
Practice Address - Street 2:SUITE 100
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71106-6739
Practice Address - Country:US
Practice Address - Phone:318-868-0830
Practice Address - Fax:318-868-7260
Is Sole Proprietor?:No
Enumeration Date:2009-07-09
Last Update Date:2013-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA59821223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice