D Sim Siceloff DDS PA

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

D SIM SICELOFF DDS PA

Practice address

19 East Second Avenue
Lexington, NC 27292

Phone

(336) 249-6524

Fax

(336) 248-1060

NPI assigned

Nov 1, 2006

Last updated

Apr 8, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

David Simeon Siceloff III, DDSNPI 1417294109

Title

President

Phone

(336) 249-6524

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• D Sim Siceloff III DDS Former legal business name

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• David Sim Siceloff, DDS

  • Dentist
  • Lexington, NC
  • NPI 1417294109
  NPD (past) Authorized official

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207612800000",
    "number": "1902983067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 848",
            "address_2": "19 EAST SECOND AVENUE",
            "city": "LEXINGTON",
            "state": "NC",
            "postal_code": "27292",
            "telephone_number": "336-249-6524",
            "fax_number": "336-248-1060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 EAST SECOND AVENUE",
            "city": "LEXINGTON",
            "state": "NC",
            "postal_code": "27292",
            "telephone_number": "336-249-6524",
            "fax_number": "336-248-1060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "D SIM SICELOFF DDS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-01",
        "last_updated": "2008-04-08",
        "status": "A",
        "authorized_official_last_name": "SICELOFF",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "SIMEON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "336-249-6524",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8997790",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "D Sim Siceloff III DDS",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Jeffrey Cruz Castillo, LAT, ATC
• Jimmarck Perel Castisimo Cuenta, DO
• Joseph William Cullom, M.D.
• Olivia Ralea Cundiff
• Douglas E Cutsinger, PHARM.D.
• Sara Daffron, MD
• Cherise Monet Dailey, NP
• Kierra Dalton
• Heather Dancy, DBH, LCSW, MSW
• David R Daughtry Jr., OD

• Dentist in Lexington, NC
• Providers in Lexington, NC by specialty
• Dentist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2008; 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.