Provider Demographics
NPI:1952617300
Name:DORI, SIMA (OD)
Entity Type:Individual
Prefix:
First Name:SIMA
Middle Name:
Last Name:DORI
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2204 CHERRING LN
Mailing Address - Street 2:
Mailing Address - City:DUNWOODY
Mailing Address - State:GA
Mailing Address - Zip Code:30338-5229
Mailing Address - Country:US
Mailing Address - Phone:770-399-0780
Mailing Address - Fax:
Practice Address - Street 1:2204 CHERRING LN
Practice Address - Street 2:
Practice Address - City:DUNWOODY
Practice Address - State:GA
Practice Address - Zip Code:30338-5229
Practice Address - Country:US
Practice Address - Phone:770-399-0780
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-24
Last Update Date:2010-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOPT002599152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management