Provider Demographics
NPI:1134437312
Name:SIMPSON, MICHAEL G (DDS)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:G
Last Name:SIMPSON
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13920 W CAMINO DEL SOL
Mailing Address - Street 2:STE 8
Mailing Address - City:SUN CITY WEST
Mailing Address - State:AZ
Mailing Address - Zip Code:85375-4438
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:13920 W CAMINO DEL SOL
Practice Address - Street 2:STE 8
Practice Address - City:SUN CITY WEST
Practice Address - State:AZ
Practice Address - Zip Code:85375-4438
Practice Address - Country:US
Practice Address - Phone:623-544-6900
Practice Address - Fax:623-544-9797
Is Sole Proprietor?:No
Enumeration Date:2010-09-21
Last Update Date:2010-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30.0228341223E0200X
AZD 80601223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics