Irine Sims-Komatsu, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

42230 Issued in CA

Practice address

11980 San Vicente Blvd Ste 906
Los Angeles, CA 90049-6607

Phone

(310) 207-5900

NPI assigned

Mar 22, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Irine P Sims Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1521676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521676800000",
    "number": "1740784982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11980 SAN VICENTE BLVD STE 906",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900496607",
            "telephone_number": "310-207-5900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11980 SAN VICENTE BLVD STE 906",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900496607",
            "telephone_number": "310-207-5900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMS-KOMATSU",
        "first_name": "IRINE",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-03-22",
        "last_updated": "2018-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "42230",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "IRINE",
            "last_name": "SIMS",
            "middle_name": "P",
            "credential": "DDS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Shelly Marie Simpson, LMSW
• Squire Simpson
• Stuart Simpson
• Timothy Donald Simpson
• William Simpson, M.D.
• Arlethia Sims
• Candace Renee Sims, LMFT
• Charles Arthur Sims, M.D.
• Damon Anthony Sims Jr.
• Edva Rachel Sims

• General Practice Dentistry in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2018; 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.