Provider Demographics
NPI:1861684680
Name:JENNIFER E SIMS DDS INC
Entity Type:Organization
Organization Name:JENNIFER E SIMS DDS INC
Other - Org Name:EXCELLENT SMILE BY DR JENNIFER E SIMS & ASSOCIATES INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:E
Authorized Official - Last Name:SIMS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:619-479-1214
Mailing Address - Street 1:5080 BONITA ROAD
Mailing Address - Street 2:SUITE N
Mailing Address - City:BONITA
Mailing Address - State:CA
Mailing Address - Zip Code:91902
Mailing Address - Country:US
Mailing Address - Phone:619-479-1214
Mailing Address - Fax:619-479-2792
Practice Address - Street 1:5080 BONITA ROAD
Practice Address - Street 2:SUITE N
Practice Address - City:BONITA
Practice Address - State:CA
Practice Address - Zip Code:91902
Practice Address - Country:US
Practice Address - Phone:619-479-1214
Practice Address - Fax:619-479-2792
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-15
Last Update Date:2007-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA44259122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty