Theresa A Simmons, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

DN013314 Issued in GA

Practice address

410 Stevens Entry
Peachtree City, GA 30269-4050

Phone

(770) 487-8882

Fax

(770) 486-9469

NPI assigned

Mar 8, 2010

Last updated

Mar 8, 2010By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1268006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1268006400000",
    "number": "1154644979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 STEVENS ENTRY",
            "city": "PEACHTREE CITY",
            "state": "GA",
            "postal_code": "302694050",
            "telephone_number": "770-487-8882",
            "fax_number": "770-486-9469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 STEVENS ENTRY",
            "city": "PEACHTREE CITY",
            "state": "GA",
            "postal_code": "302694050",
            "telephone_number": "770-487-8882",
            "fax_number": "770-486-9469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMMONS",
        "first_name": "THERESA",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-08",
        "last_updated": "2010-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "GA",
            "license": "DN013314",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shyne Lite Imaging Solutions LLC
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• Gary Steven Siliski, LPC
• Farren Simmons, P.T.A.
• Jennilyn Alexis Simmons, MSN,FNP-C
• Kelly Simpson, HADS1014
• Sofia Elizabeth Siraj, CRC, APC, NCC
• Elizabeth Ann Sisselman, RD, LDN
• Skye Medical Solutions Group
• Skyeview Dental, LLC

• Dentist in Peachtree City, GA
• Providers in Peachtree City, GA by specialty
• Dentist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2010; 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.