Provider Demographics
NPI:1801218755
Name:SIMIAN, KAMYAR (DMD)
Entity Type:Individual
Prefix:DR
First Name:KAMYAR
Middle Name:
Last Name:SIMIAN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:DR
Other - First Name:KAMY
Other - Middle Name:
Other - Last Name:SIMIAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DMD
Mailing Address - Street 1:1201 PEACHTREE ST NE
Mailing Address - Street 2:BUILDING 400 - SUITE 1515
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30361-3503
Mailing Address - Country:US
Mailing Address - Phone:404-892-3545
Mailing Address - Fax:404-875-0349
Practice Address - Street 1:1201 PEACHTREE ST NE
Practice Address - Street 2:BUILDING 400 - SUITE 1515
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30361-3503
Practice Address - Country:US
Practice Address - Phone:404-892-3545
Practice Address - Fax:404-875-0349
Is Sole Proprietor?:No
Enumeration Date:2014-01-13
Last Update Date:2014-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN0146221223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice