Benjamin Jon-Spoon Simonton, DDS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

2901020047 Issued in MI

Practice address

4646 Nantuckett Ste a
Toledo, OH 43623-3194

Phone

(419) 517-2100

Fax

(419) 517-2104

NPI assigned

Jun 30, 2009

Sex

Male

Sole proprietor

Yes

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

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Aug 4, 2025 through Aug 4, 2027

Medicare enrollment (NPD)

Enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: bsimonton295878@direct.hfhs.org

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

{
    "created_epoch": "1246320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488844800000",
    "number": "1306074232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4646 NANTUCKETT STE. A",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436233194",
            "telephone_number": "419-517-2100",
            "fax_number": "419-517-2104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4646 NANTUCKETT STE A",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436233194",
            "telephone_number": "419-517-2100",
            "fax_number": "419-517-2104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMONTON",
        "first_name": "BENJAMIN",
        "middle_name": "JON-SPOON",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-06-30",
        "last_updated": "2017-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MI",
            "license": "2901020047",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa Simon, MA CCC-SLP
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• Mikayla Marie Simon
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• Earl Simpkins IV, CNP
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• Simone Simpson Myers

• Oral and Maxillofacial Surgery (Dentist) in Toledo, OH
• Providers in Toledo, OH by specialty
• Oral and Maxillofacial Surgery (Dentist) in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2017; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.