Provider Demographics
NPI:1831649003
Name:SIMPLICITY DENTAL, INC.
Entity Type:Organization
Organization Name:SIMPLICITY DENTAL, INC.
Other - Org Name:WASHBURN SMILES, INC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KATHRYN
Authorized Official - Middle Name:ELAINE
Authorized Official - Last Name:MCATEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-887-2458
Mailing Address - Street 1:2650 WASHBURN WAY
Mailing Address - Street 2:SUITE 210
Mailing Address - City:KLAMATH FALLS
Mailing Address - State:OR
Mailing Address - Zip Code:97603-4596
Mailing Address - Country:US
Mailing Address - Phone:541-885-5578
Mailing Address - Fax:541-885-5453
Practice Address - Street 1:2650 WASHBURN WAY
Practice Address - Street 2:SUITE 210
Practice Address - City:KLAMATH FALLS
Practice Address - State:OR
Practice Address - Zip Code:97603-4596
Practice Address - Country:US
Practice Address - Phone:541-885-5578
Practice Address - Fax:541-885-5453
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-11
Last Update Date:2021-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty