Ethan Zachary Simpson, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

12008 Issued in NC

Practice address

904 Spivey Rd
Whiteville, NC 28472-2915

Phone

(910) 642-6500

NPI assigned

Jul 14, 2020

Last updated

May 6, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1594684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620259200000",
    "number": "1447868609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 367",
            "city": "LAKE WACCAMAW",
            "state": "NC",
            "postal_code": "284500367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "904 SPIVEY RD",
            "city": "WHITEVILLE",
            "state": "NC",
            "postal_code": "284722915",
            "telephone_number": "910-642-6500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMPSON",
        "first_name": "ETHAN",
        "middle_name": "ZACHARY",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-07-14",
        "last_updated": "2021-05-06",
        "certification_date": "2020-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "12008",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shoreland Healthcare & Retirement Center Inc
• Shoreland Healthcare and Retirement Center Inc
• Signet Healthcare, PC
• Lauren W. Simmons, APRN, FNP-C
• Selena Patrick Simmons, FNP-C
• Quinn La'Shawn Singletary
• Smith Chiropractic and Wellness (Schultz - Ellis Chiropractic)
• Alayna Rachel Smith, MSW, LCSW
• Andrew Garland Smith III, DC
• Sheeketa Bellamy Smith

• General Practice Dentistry in Whiteville, NC
• Providers in Whiteville, NC by specialty
• General Practice Dentistry in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2021; 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.