S.L. Simmons-Boyd, D.D.S., P.a.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

6088 Issued in NC

Legal business name

S.L. SIMMONS-BOYD, D.D.S., P.A.

Practice address

725 Providence Rd
Suite 301
Charlotte, NC 28207-2260

Phone

(704) 376-1696

Fax

(704) 376-1698

NPI assigned

Feb 27, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Sandra Simmons-Boyd, D.D.S

Title

President

Phone

(704) 376-1696

Specialties & licenses 1

Addresses

Other identifiers 3

Locations

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

{
    "created_epoch": "1204070400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1218758400000",
    "number": "1609045335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "725 PROVIDENCE RD",
            "address_2": "SUITE 301",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282072370",
            "telephone_number": "704-376-1696",
            "fax_number": "704-376-1698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 PROVIDENCE RD",
            "address_2": "SUITE 301",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282072260",
            "telephone_number": "704-376-1696",
            "fax_number": "704-376-1698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "S.L. SIMMONS-BOYD, D.D.S., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-27",
        "last_updated": "2008-08-15",
        "status": "A",
        "authorized_official_last_name": "SIMMONS-BOYD",
        "authorized_official_first_name": "SANDRA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "704-376-1696",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "6088",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER NUMBER",
            "identifier": "97795",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8997795",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NC STATE LICENSE",
            "identifier": "6088",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Charlotte, NC
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2008; 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.