Individual provider Active NPI

Harvey P Simon, D.M.D.

  • Endodontics
  • Buford, GA
National Provider Identifier
1700937406
Registry record updated May 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
DN122926 Issued in GA
Practice address
3687 Buford Dr
Ste. 300
Buford, GA 30519
Phone
(470) 317-2078
Fax
(203) 222-0129
NPI assigned
Jan 16, 2007
Last updated
May 22, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 22, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X 7788 CT
Endodontics 1223E0200X DN122926 GA Primary

Addresses

Primary practice location

3687 Buford Dr
Ste. 300
Buford, GA 30519

Mailing address

225 Main St
Ste. 201
Westport, CT 06880-3216
Phone (203) 222-9553

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
7788CTMDProfessional Counselor
DN122926GAMDEndodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Dentists of Buford, PC PastSince May 26, 2024 Accepting new patients
Woodstock Dentistry, PC Past Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716336000000",
    "number": "1700937406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 MAIN ST",
            "address_2": "STE. 201",
            "city": "WESTPORT",
            "state": "CT",
            "postal_code": "068803216",
            "telephone_number": "203-222-9553",
            "fax_number": "203-222-0129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3687 BUFORD DR",
            "address_2": "STE. 300",
            "city": "BUFORD",
            "state": "GA",
            "postal_code": "30519",
            "telephone_number": "470-317-2078",
            "fax_number": "203-222-0129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMON",
        "first_name": "HARVEY",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-16",
        "last_updated": "2024-05-22",
        "certification_date": "2024-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "CT",
            "license": "7788",
            "primary": false
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "GA",
            "license": "DN122926",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buford, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2024; 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.