Provider Demographics
NPI:1013306430
Name:SIMON, HAREL (DMD)
Entity Type:Individual
Prefix:DR
First Name:HAREL
Middle Name:
Last Name:SIMON
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 1:416 N BEDFORD DR
Mailing Address - Street 2:SUITE #404
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90210-4322
Mailing Address - Country:US
Mailing Address - Phone:310-275-6236
Mailing Address - Fax:
Practice Address - Street 1:416 N BEDFORD DR
Practice Address - Street 2:SUITE #404
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90210-4322
Practice Address - Country:US
Practice Address - Phone:310-275-6236
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-22
Last Update Date:2015-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA500981223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics