Provider Demographics
NPI:1932725249
Name:SIMPSON, STEVEN W (DMD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:W
Last Name:SIMPSON
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CMR 402 UNIT 33100
Mailing Address - Street 2:
Mailing Address - City:APO
Mailing Address - State:AE
Mailing Address - Zip Code:09180
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:CMR 402
Practice Address - Street 2:UNIT 33100
Practice Address - City:APO
Practice Address - State:NY
Practice Address - Zip Code:09180
Practice Address - Country:US
Practice Address - Phone:270-412-8545
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-23
Last Update Date:2022-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN113051223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN11305OtherTN DENTAL LICENSE