St. Simons Island Dental Associates, PC

Primary specialty

DentistTaxonomy code 122300000X

License

DN011726 Issued in GA

Legal business name

ST. SIMONS ISLAND DENTAL ASSOCIATES, PC

Practice address

2487 Demere Rd
Ste 100
St Simons Island, GA 31522-5639

Phone

(912) 638-9921

Fax

(912) 638-4121

NPI assigned

Feb 12, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Paul E Thompson, DMD

Title

Dentist

Phone

(912) 638-9921

Specialties & licenses 3

Addresses

Locations

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Island Dental Partners, LLC

  • Dentist
  • St Simons Island, GA
  • NPI 1649164898
  NPPES parent name

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1171238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737590400000",
    "number": "1003958638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2487 DEMERE RD STE 100",
            "address_2": "PO BOX 20326",
            "city": "ST SIMONS ISLAND",
            "state": "GA",
            "postal_code": "315225640",
            "telephone_number": "912-638-9921",
            "fax_number": "912-638-4121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2487 DEMERE RD",
            "address_2": "STE 100",
            "city": "ST SIMONS ISLAND",
            "state": "GA",
            "postal_code": "315225639",
            "telephone_number": "912-638-9921",
            "fax_number": "912-638-4121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. SIMONS ISLAND DENTAL ASSOCIATES, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-12",
        "last_updated": "2025-01-23",
        "certification_date": "2025-01-23",
        "status": "A",
        "authorized_official_last_name": "THOMPSON",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "912-638-9921",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "GA",
            "license": "DN011726",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "GA",
            "license": "DN012532",
            "primary": false
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Spencer Spine Specialists LLC
• Ashleigh Dehnea Spencer, D.C.
• St Simons Eye Care, LLC
• St Simons Island Clinic
• St. Simons Dental Partners LLC
• St. Simons Psychiatry, LLC
• Horace Stringfellow V, PT
• Julie S Sullens, DPT
• Lisia A Sullins, NP
• Emma Anne Summers, DPT

• Dentist in St Simons Island, GA
• Providers in St Simons Island, GA by specialty
• Dentist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.