Provider Demographics
NPI:1265574701
Name:SIMS, TIMOTHY DEYOUNG (DDS)
Entity type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:DEYOUNG
Last Name:SIMS
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 1:114 FOX TRAP CT
Mailing Address - Street 2:
Mailing Address - City:GARNER
Mailing Address - State:NC
Mailing Address - Zip Code:27529-8284
Mailing Address - Country:US
Mailing Address - Phone:919-773-2255
Mailing Address - Fax:
Practice Address - Street 1:606 BUFFALO RD
Practice Address - Street 2:
Practice Address - City:SMITHFIELD
Practice Address - State:NC
Practice Address - Zip Code:27577-7451
Practice Address - Country:US
Practice Address - Phone:919-989-8805
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2012-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC72311223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5903462Medicaid