Bryan J Simone, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

19692 Issued in OH

Practice address

4178 Hoover Rd
Grove City, OH 43123-3625

Phone

(614) 875-3141

NPI assigned

May 2, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1178064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568937600000",
    "number": "1154543296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4178 HOOVER RD",
            "city": "GROVE CITY",
            "state": "OH",
            "postal_code": "431233625",
            "telephone_number": "614-875-3141",
            "fax_number": "614-875-8812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4178 HOOVER RD",
            "city": "GROVE CITY",
            "state": "OH",
            "postal_code": "431233625",
            "telephone_number": "614-875-3141"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4104 Broadway",
            "address_purpose": "LOCATION",
            "city": "Grove City",
            "state": "OH",
            "postal_code": "43123",
            "country_code": "US",
            "telephone_number": "614-875-3141",
            "fax_number": "614-875-8812",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIMONE",
        "first_name": "BRYAN",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-02",
        "last_updated": "2019-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "19692",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0893636",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kim C Shorr, AUD FAAA
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• Cailey Sigler
• Russell John Simon I, LPCC-S
• Kellee N Sims-Clark, LCDCIII 121101
• Minakshi Sardha Singh, MD
• Ravjot Singh, DDS
• Sukhjit Singh
• Jean Sinkey

• Dentist in Grove City, OH
• Providers in Grove City, OH by specialty
• Dentist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.