Provider Demographics
NPI:1720374317
Name:SIMPSON, ELIZABETH VI (DMD)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:VI
Last Name:SIMPSON
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:181 BROOKRIDGE TRL
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37211-4779
Mailing Address - Country:US
Mailing Address - Phone:317-918-4306
Mailing Address - Fax:
Practice Address - Street 1:181 BROOKRIDGE TRL
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37211-4779
Practice Address - Country:US
Practice Address - Phone:317-918-4306
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-22
Last Update Date:2011-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN12345678122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist