Provider Demographics
NPI:1508087479
Name:SIMPSON, MICHAEL RYON (DMD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:RYON
Last Name:SIMPSON
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1445 E MITCHELL HAMMOCK RD
Mailing Address - Street 2:
Mailing Address - City:OVIEDO
Mailing Address - State:FL
Mailing Address - Zip Code:32765-9144
Mailing Address - Country:US
Mailing Address - Phone:407-977-6464
Mailing Address - Fax:407-977-9989
Practice Address - Street 1:1445 E MITCHELL HAMMOCK RD
Practice Address - Street 2:
Practice Address - City:OVIEDO
Practice Address - State:FL
Practice Address - Zip Code:32765-9144
Practice Address - Country:US
Practice Address - Phone:407-977-6464
Practice Address - Fax:407-977-9989
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2014-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN14132122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist