Individual provider Active NPI

Gerard Louis Simoneaux, D.D.S

  • Endodontics
  • Baltimore, MD
National Provider Identifier
1366474272
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
13445 Issued in MD
Practice address
7939 Honeygo Blvd
Suite 227
Baltimore, MD 21236-4931
Phone
(410) 931-0250
Fax
(410) 931-4876
NPI assigned
Jul 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X 13445 MD Primary

Addresses

Primary practice location

7939 Honeygo Blvd
Suite 227
Baltimore, MD 21236-4931

Mailing address

619 Yarmouth Rd
Baltimore, MD 21286-7838
Phone (410) 377-5870

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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

Enrollment IDStateProvider typePAC IDDetails
I20160420001703 MD Order and Referring Only - DentistPractitioner - Dentist 7214235415

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1366474272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "619 YARMOUTH RD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212867838",
            "telephone_number": "410-377-5870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7939 HONEYGO BLVD",
            "address_2": "SUITE 227",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212364931",
            "telephone_number": "410-931-0250",
            "fax_number": "410-931-4876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMONEAUX",
        "first_name": "GERARD",
        "middle_name": "LOUIS",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "MD",
            "license": "13445",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.