Individual provider Active NPI

Deepa Nmi Simon, D.D.S.

  • General Practice Dentistry
  • Richmond, VA
National Provider Identifier
1295824407
Registry record updated Sep 20, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
0401411005 Issued in VA
Practice address
2924 Brook Rd
Credentialing Dept
Richmond, VA 23220-1298
Phone
(804) 321-7474
Fax
(804) 228-5970
NPI assigned
Oct 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 0401411005 VA Primary

Addresses

Primary practice location

2924 Brook Rd
Credentialing Dept
Richmond, VA 23220-1298

Mailing address

2924 Brook Rd
Credentialing Dept
Richmond, VA 23220-1298
Phone (804) 321-7474

Other identifiers 1

IdentifierTypeStateIssuer
0401411005OtherVAPROFESIONAL LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
0401411005VAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1284940800000",
    "number": "1295824407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2924 BROOK RD",
            "address_2": "CREDENTIALING DEPT",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232201298",
            "telephone_number": "804-321-7474",
            "fax_number": "804-228-5970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2924 BROOK RD",
            "address_2": "CREDENTIALING DEPT",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232201298",
            "telephone_number": "804-321-7474",
            "fax_number": "804-228-5970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMON",
        "first_name": "DEEPA",
        "middle_name": "NMI",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-12",
        "last_updated": "2010-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401411005",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROFESIONAL LICENSE",
            "identifier": "0401411005",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2010; 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.