Individual provider Active NPI

Mark Andrew Simmons, D.D.S.

  • Dentist
  • La Vernia, TX
National Provider Identifier
1710970389
Registry record updated Sep 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
TX14122 Issued in TX
Practice address
101 Villas Dr
La Vernia, TX 78121-4491
Phone
(830) 779-6511
Fax
(830) 779-1711
NPI assigned
Aug 29, 2005
Reactivated
Mar 22, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 14, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X TX14122 TX Primary

Addresses

Primary practice location

101 Villas Dr
La Vernia, TX 78121-4491

Mailing address

101 Villas Dr
La Vernia, TX 78121-4491
Phone (830) 779-6511

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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

Enrollment IDStateProvider typePAC IDDetails
I20240529002818 TX Practitioner - Dentist 4284934852 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dentist
Education
The Dental School at University of Texas HSC at San Antonio, 1984
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

101 Villas Dr
La Vernia, TX 78121-4491
Phone (830) 436-2055

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
14122TXMDClinical Social Worker
TX14122TXMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Sleep Better la Vernia PLLC General Practice CurrentSince Dec 26, 2023 Accepting new patients
La Vernia Dental General Practice CurrentSince Jan 1, 2020 Accepting new patients
La Vernia Sleep Solutions LLC Current Accepting new patients

Locations

101 Villas Dr
La Vernia, TX 78121
Phone (830) 436-2055

13549 US Highway 87 W
La Vernia, TX 78121
Phone (830) 779-6500

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1125273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789344000000",
    "number": "1710970389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 VILLAS DR",
            "city": "LA VERNIA",
            "state": "TX",
            "postal_code": "781214491",
            "telephone_number": "830-779-6511",
            "fax_number": "830-779-1711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 VILLAS DR",
            "city": "LA VERNIA",
            "state": "TX",
            "postal_code": "781214491",
            "telephone_number": "830-779-6511",
            "fax_number": "830-779-1711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMMONS",
        "first_name": "MARK",
        "middle_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-29",
        "last_updated": "2026-09-14",
        "certification_date": "2026-09-14",
        "deactivation_date": "2006-03-17",
        "reactivation_date": "2006-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "TX14122",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Vernia, TX

Sources for this page

Verify at the official NPI Registry.