Provider Demographics
NPI:1821844689
Name:SIMPLY SMILES
Entity type:Organization
Organization Name:SIMPLY SMILES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:GODFREY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:515-360-0393
Mailing Address - Street 1:348 SE CEDARWOOD DR
Mailing Address - Street 2:
Mailing Address - City:GRIMES
Mailing Address - State:IA
Mailing Address - Zip Code:50111-1143
Mailing Address - Country:US
Mailing Address - Phone:515-360-0393
Mailing Address - Fax:
Practice Address - Street 1:348 SE CEDARWOOD DR
Practice Address - Street 2:
Practice Address - City:GRIMES
Practice Address - State:IA
Practice Address - Zip Code:50111-1143
Practice Address - Country:US
Practice Address - Phone:515-360-0393
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-24
Last Update Date:2024-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty
No251G00000XAgenciesHospice Care, Community BasedGroup - Multi-Specialty
No251J00000XAgenciesNursing Care
No251K00000XAgenciesPublic Health or Welfare