Provider Demographics
NPI:1689739641
Name:SIMMONS, AARON DAVID (DMD)
Entity Type:Individual
Prefix:DR
First Name:AARON
Middle Name:DAVID
Last Name:SIMMONS
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 1:1101 N. CENTRAL AVENUE
Mailing Address - Street 2:MARICOPA INTEGRATED HEALTH SYSTEM
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85004
Mailing Address - Country:US
Mailing Address - Phone:602-344-6568
Mailing Address - Fax:602-344-6560
Practice Address - Street 1:1101 N. CENTRAL AVENUE
Practice Address - Street 2:MARICOPA INTEGRATED HEALTH SYSTEM
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85004
Practice Address - Country:US
Practice Address - Phone:602-344-6568
Practice Address - Fax:602-344-6560
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-27
Last Update Date:2017-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV55181223G0001X
AZ96461223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice