Provider Demographics
NPI:1568653640
Name:SIMMS, BARRY
Entity Type:Individual
Prefix:
First Name:BARRY
Middle Name:
Last Name:SIMMS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5875 LANDERBROOK DR STE 250
Mailing Address - Street 2:
Mailing Address - City:MAYFIELD HTS
Mailing Address - State:OH
Mailing Address - Zip Code:44124-6502
Mailing Address - Country:US
Mailing Address - Phone:800-487-4867
Mailing Address - Fax:216-593-7533
Practice Address - Street 1:5875 LANDERBROOK DR STE 250
Practice Address - Street 2:
Practice Address - City:MAYFIELD HTS
Practice Address - State:OH
Practice Address - Zip Code:44124-6502
Practice Address - Country:US
Practice Address - Phone:800-487-4867
Practice Address - Fax:216-593-7533
Is Sole Proprietor?:No
Enumeration Date:2007-08-05
Last Update Date:2007-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30.0205511223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics