Provider Demographics
NPI:1669273926
Name:SIMON TOADER DMD LLC
Entity type:Organization
Organization Name:SIMON TOADER DMD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SIMON
Authorized Official - Middle Name:
Authorized Official - Last Name:TOADER
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:360-903-9380
Mailing Address - Street 1:17349 SW JEAN LOUISE RD
Mailing Address - Street 2:
Mailing Address - City:SHERWOOD
Mailing Address - State:OR
Mailing Address - Zip Code:97140-9317
Mailing Address - Country:US
Mailing Address - Phone:360-903-9380
Mailing Address - Fax:
Practice Address - Street 1:331 SE 3RD AVE
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97123-4001
Practice Address - Country:US
Practice Address - Phone:360-903-9380
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-22
Last Update Date:2025-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental