Blair Tiburcio Simeon, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN22742 Issued in FL

Practice address

8440 Blanding Blvd
Jacksonville, FL 32244-5725

Phone

(904) 525-8041

NPI assigned

Jun 15, 2017

Sex

Female

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 FL

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

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• South Jacksonville Dental PLLC

  • General Practice Dentistry
  • Jacksonville, FL
  • NPI 1003287814
  NPD (past)

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

{
    "created_epoch": "1497484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1417487984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8049 MACINNES DR E",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322445579",
            "telephone_number": "808-389-6550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8440 BLANDING BLVD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322445725",
            "telephone_number": "904-525-8041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMEON",
        "first_name": "BLAIR",
        "middle_name": "TIBURCIO",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-15",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN22742",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marcella Lee Silverton, PT
• Shannon Elisabeth Silvestri, LMHC
• Holly Silvia
• Maria Angelica O Sim, OTR/L
• Michon Simanoff
• Amy Christine Simmens, PA-C
• Yarelies Malave Simmonds, M.D.
• Bethanie M Simmons Becil, PMHNP
• Simmons Pediatrics
• Bianca Sue Simmons, LMT

• General Practice Dentistry in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• General Practice Dentistry in Florida

• 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.
• 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.