Taylor Antione Sims, DDS

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

12325 Issued in TN

Practice address

510 S Jefferson Ave
Cookeville, TN 38501-4010

Phone

(931) 854-1200

NPI assigned

Jul 13, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Spark Dental TN, PLLC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Smyrna, TN
  • NPI 1154087120

  Pediatric Dentistry

  NPD (past)

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

{
    "created_epoch": "1626134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698105600000",
    "number": "1093387771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "179 LOBLOLLY LN",
            "city": "MONROEVILLE",
            "state": "AL",
            "postal_code": "364601619",
            "telephone_number": "251-593-2700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 S JEFFERSON AVE",
            "city": "COOKEVILLE",
            "state": "TN",
            "postal_code": "385014010",
            "telephone_number": "931-854-1200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMS",
        "first_name": "TAYLOR",
        "middle_name": "ANTIONE",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-07-13",
        "last_updated": "2023-10-24",
        "certification_date": "2023-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TN",
            "license": "12325",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "TN",
            "license": "12325",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jonas Vytas Sidrys, M.D.
• Stacy Siegers, M.A.,CCC/SLP
• David Rome Silvey, DC
• Robert Louis Simon, SA
• Lora M. Simpson, R.D.
• Rajiv Sinanan, MBBS
• James Sircy, DPT
• Stephen J Sisko, M.D.
• Melissa Ann Sitts, MS
• Skin & Aesthetics TN

• Pediatric Dentistry in Cookeville, TN
• Providers in Cookeville, TN by specialty
• Pediatric Dentistry in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2023; 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.