Individual provider Active NPI

Steven M Simmons, DMD

  • General Practice Dentistry
  • Portland, OR
National Provider Identifier
1790820025
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
5598 Issued in OR
Practice address
833 SW 11TH
Suite 800
Portland, OR 97205
Phone
(503) 223-4993
Fax
(503) 223-7225
NPI assigned
Feb 21, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 5598 OR Primary

Addresses

Primary practice location

833 SW 11TH
Suite 800
Portland, OR 97205

Mailing address

833 SW 11TH
Suite 800
Portland, OR 97205
Phone (503) 223-4993

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

NPI Registry JSON

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

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1790820025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "833 SW 11TH",
            "address_2": "SUITE 800",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97205",
            "telephone_number": "503-223-4993",
            "fax_number": "503-223-7225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "833 SW 11TH",
            "address_2": "SUITE 800",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97205",
            "telephone_number": "503-223-4993",
            "fax_number": "503-223-7225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMMONS",
        "first_name": "STEVEN",
        "middle_name": "M",
        "name_prefix": "Mr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "5598",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

  • 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.