Keith Simon, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

DN21658 Issued in FL

Practice address

4340 W Hillsborough Ave Ste 702
Tampa, FL 33614-5560

Phone

(813) 445-3240

NPI assigned

Apr 20, 2015

Sex

Male

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

Locations

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.

• Simonsmiles, P.a.

  • Dental Clinic/Center
  • Tampa, FL
  • NPI 1841855566
  NPD Authorized official

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

{
    "created_epoch": "1429488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628640000000",
    "number": "1457748154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4340 W HILLSBOROUGH AVE STE 702",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336145560",
            "telephone_number": "813-722-1050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4340 W HILLSBOROUGH AVE STE 702",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336145560",
            "telephone_number": "813-445-3240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMON",
        "first_name": "KEITH",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-20",
        "last_updated": "2021-08-11",
        "certification_date": "2021-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN21658",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Diona Silas Simms, FNP-BC
• Lisa Marie Simms
• Michael Simoes, MD
• James William Simon, APRN
• Jerry Gordon Simon
• Reema Elalam Simon, DO
• Ross Simon, MD
• Shannon Simon, LPN/NRP
• Carissa Simone, M.D.
• Isabella Marie Simone

• Dentist in Tampa, FL
• Providers in Tampa, FL by specialty
• Dentist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2021; 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.