Simply Wisdom Teeth PLLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

143297 Issued in UT

Legal business name

SIMPLY WISDOM TEETH PLLC

Practice address

352 E Riverside Dr Ste A9
Saint George, UT 84790-5812

Phone

(435) 652-1243

Fax

(435) 652-1243

NPI assigned

Aug 16, 2017

Organization subpart

No

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

Authorized official

Name

Mr. Niels Hendrickson

Title

Manager

Phone

(435) 215-6621

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1502841600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1255857728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "352 E RIVERSIDE DR STE A9",
            "city": "SAINT GEORGE",
            "state": "UT",
            "postal_code": "847905812",
            "telephone_number": "435-652-1243",
            "fax_number": "435-652-1243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "352 E RIVERSIDE DR STE A9",
            "city": "SAINT GEORGE",
            "state": "UT",
            "postal_code": "847905812",
            "telephone_number": "435-652-1243",
            "fax_number": "435-652-1243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SIMPLY WISDOM TEETH PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-16",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "HENDRICKSON",
        "authorized_official_first_name": "NIELS",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "435-215-6621",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "UT",
            "license": "143297",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "528948205",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Summer Simon
• Brian S Simons, PA-C
• Randy T Simonsen, DDS
• Simple Behavior Solutions LLC
• Simply Health Chiropractic Center PLLC
• Carly Simpson, DMD
• Karynne Kimberly Simpson
• Neil Bradley Simpson, LCSW
• Shannon Sinclair, LCSW
• Leigha Singh

• Dental Clinic/Center in Saint George, UT
• Providers in Saint George, UT by specialty
• Dental Clinic/Center in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.