Active NPI
Alec Jordan Simonson, DMD, MS
- Dentist
- Lake Wales, FL
National Provider Identifier
1780476994
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DN30248
- Practice address
- 24174 US 27 Ste 200
Lake Wales, FL 33859-7807 - Phone
- (863) 679-3229
- NPI assigned
- May 22, 2025
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DN30248 | FL | Primary |
Addresses
Primary practice location
24174 US 27 Ste 200
Lake Wales, FL 33859-7807
Mailing address
16300 County Road 455 Unit 216
Montverde, FL 34756-3643
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN30248 | FL | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Comfortable Care Dental Health Professionals | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- General Practice Dentistry
- Lake Wales, FL
- NPI 1184977134
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1747872000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1747872000000",
"number": "1780476994",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16300 COUNTY ROAD 455 UNIT 216",
"city": "MONTVERDE",
"state": "FL",
"postal_code": "347563643"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "24174 US 27 STE 200",
"city": "LAKE WALES",
"state": "FL",
"postal_code": "338597807",
"telephone_number": "863-679-3229"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SIMONSON",
"first_name": "ALEC",
"middle_name": "JORDAN",
"name_prefix": "Dr.",
"credential": "DMD, MS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2025-05-22",
"last_updated": "2025-05-22",
"certification_date": "2025-05-22",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "FL",
"license": "DN30248",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lake Wales, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.