Anthony Michael Simon, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

D7248 Issued in OR

Practice address

1700 E 12TH St
The Dalles, OR 97058

Phone

(541) 298-4403

Fax

(541) 298-4403

NPI assigned

Oct 5, 2006

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 OR, ND2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Heritage Family Dentistry LLC

  • General Practice Dentistry
  • The Dalles, OR
  • NPI 1538997796
  NPD (past)

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1720174709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 E 12TH ST",
            "city": "THE DALLES",
            "state": "OR",
            "postal_code": "97058",
            "telephone_number": "541-298-4403",
            "fax_number": "541-298-4469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 E 12TH ST",
            "city": "THE DALLES",
            "state": "OR",
            "postal_code": "97058",
            "telephone_number": "541-298-4403",
            "fax_number": "541-298-4403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMON",
        "first_name": "ANTHONY",
        "middle_name": "MICHAEL",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OR",
            "license": "D7248",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Diane Elizabeth Shewey
• Sonia Shishido, DO
• James Brent Sholar, M.D.
• Jill Melody Silk
• John Robert Simmons
• Susan E Sisko, LPC
• Dena Sites, LCSW, CHC
• Shira Skybinskyy, QMHP
• Brooke Kaylynn Small
• Jenger Smith Cole

• Dentist in The Dalles, OR
• Providers in The Dalles, OR by specialty
• Dentist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.