Dwight Simmons, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019025863 Issued in IL

Practice address

27620 75TH St
Suite 3
Salem, WI 53168-9530

Phone

(262) 843-1808

NPI assigned

Jul 27, 2006

Last updated

Apr 24, 2012By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in WI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• 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": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1335225600000",
    "number": "1184638207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19445 W FOREST LN",
            "city": "MUNDELEIN",
            "state": "IL",
            "postal_code": "600603496",
            "telephone_number": "847-393-7100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27620 75TH ST",
            "address_2": "SUITE 3",
            "city": "SALEM",
            "state": "WI",
            "postal_code": "531689530",
            "telephone_number": "262-843-1808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMMONS",
        "first_name": "DWIGHT",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2012-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019025863",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Linda Ann Schlichting, RN
• Paul Norman Schmidt, MPT
• Kimberly Schmitt
• Paul Tanner Shaffer
• Debra Shufelt, OTR
• Sarah Singleton, MA, CCC/SLP
• Adam Slade
• Brittany Smart, DPT
• Smith Chiropractic Office S.C.
• Bradley J. Smith, D.C.

• General Practice Dentistry in Salem, WI
• Providers in Salem, WI by specialty
• General Practice Dentistry in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2012; 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.