Provider Demographics
NPI:1932724572
Name:SIMMS, JASON ALLEN (DDS)
Entity Type:Individual
Prefix:DR
First Name:JASON
Middle Name:ALLEN
Last Name:SIMMS
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 1:20377 OLD SCENIC HWY STE 206
Mailing Address - Street 2:
Mailing Address - City:ZACHARY
Mailing Address - State:LA
Mailing Address - Zip Code:70791-7366
Mailing Address - Country:US
Mailing Address - Phone:225-570-4050
Mailing Address - Fax:225-570-4049
Practice Address - Street 1:20377 OLD SCENIC HWY STE 206
Practice Address - Street 2:
Practice Address - City:ZACHARY
Practice Address - State:LA
Practice Address - Zip Code:70791-7366
Practice Address - Country:US
Practice Address - Phone:225-570-4050
Practice Address - Fax:225-570-4049
Is Sole Proprietor?:No
Enumeration Date:2020-06-09
Last Update Date:2023-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA7080122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist