Provider Demographics
NPI:1568424786
Name:SIMPSON, JARED SCOTT (DDS)
Entity Type:Individual
Prefix:
First Name:JARED
Middle Name:SCOTT
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 1:12301 CROWN CREST DR
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93311-8503
Mailing Address - Country:US
Mailing Address - Phone:661-654-0243
Mailing Address - Fax:661-632-2147
Practice Address - Street 1:234 BAKER ST STE 6
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93305-5856
Practice Address - Country:US
Practice Address - Phone:661-632-2144
Practice Address - Fax:661-632-2147
Is Sole Proprietor?:No
Enumeration Date:2006-04-04
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD6587122300000X
CA54553122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ994617Medicaid