Paul L Simon, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2901013028 Issued in MI

Practice address

21800 Pontiac Trail Ste 100
South Lyon, MI 48178

Phone

(248) 437-8300

Fax

(248) 437-8066

NPI assigned

Apr 22, 2008

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 MI

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1208822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208822400000",
    "number": "1770757700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21800 PONTIAC TRAIL STE 100",
            "city": "SOUTH LYON",
            "state": "MI",
            "postal_code": "48178",
            "telephone_number": "248-437-8300",
            "fax_number": "248-437-8066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21800 PONTIAC TRAIL STE 100",
            "city": "SOUTH LYON",
            "state": "MI",
            "postal_code": "48178",
            "telephone_number": "248-437-8300",
            "fax_number": "248-437-8066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMON",
        "first_name": "PAUL",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-22",
        "last_updated": "2008-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901013028",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Therese F Shortt, DDS
• William A Shortt, DDS
• Isabelle N Shoup, PTA
• Diana Rebecca Silas, DO
• Silverback, Inc. (Discover Chiropractic Now)
• Robin Lynn-Pregitzer Simonton, DDS
• Ajanthan Sivagurunathan, M.D.
• Karen Michelle Skrzypek, LMSW, CAADC
• Ladonna Slattery
• Amy Noelle Smith, LPC

• General Practice Dentistry in South Lyon, MI
• Providers in South Lyon, MI by specialty
• General Practice Dentistry in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2008; 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.