Provider Demographics
NPI:1598982449
Name:SIMPSON, JAMES E (DMD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:E
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 1:1001 E MAIN STREET
Mailing Address - Street 2:#THREE PROFESSIONAL PARK EAST
Mailing Address - City:CARBONDALE
Mailing Address - State:IL
Mailing Address - Zip Code:62901-3100
Mailing Address - Country:US
Mailing Address - Phone:618-457-2522
Mailing Address - Fax:618-457-2577
Practice Address - Street 1:1001 E MAIN ST
Practice Address - Street 2:#3 PROFESSIONAL PARK
Practice Address - City:CARBONDALE
Practice Address - State:IL
Practice Address - Zip Code:62901-3100
Practice Address - Country:US
Practice Address - Phone:618-457-2522
Practice Address - Fax:618-457-2577
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-20
Last Update Date:2009-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019-0188341223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice