Provider Demographics
NPI:1245697473
Name:SIMUS, RONALD I (DDS)
Entity type:Individual
Prefix:DR
First Name:RONALD
Middle Name:
Last Name:SIMUS
Suffix:I
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 1:7170 INDIANA AVE
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92504-4544
Mailing Address - Country:US
Mailing Address - Phone:951-248-0567
Mailing Address - Fax:951-683-4559
Practice Address - Street 1:7170 INDIANA AVE
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92504-4544
Practice Address - Country:US
Practice Address - Phone:951-248-0567
Practice Address - Fax:951-683-4559
Is Sole Proprietor?:No
Enumeration Date:2016-01-19
Last Update Date:2016-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA387521223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics