NPIMap

Organization Active NPI

Kimberly D Simonds DDS PC

  • Dentist
  • Ballwin, MO
National Provider Identifier
1972993541
Registry record updated Feb 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
016003 Issued in MO
Legal business name
KIMBERLY D SIMONDS DDS PC
Practice address
14738 Manchester Rd
Suite B
Ballwin, MO 63011-3706
Phone
(636) 227-2552
NPI assigned
Feb 3, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2015

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

Authorized official

Name
Dr. Kimberly Dawn Simonds, DDSNPI 1346337383
Title
Dentist Owner
Phone
(636) 227-2552

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 016003 MO Primary

Addresses

Primary practice location

14738 Manchester Rd
Suite B
Ballwin, MO 63011-3706

Mailing address

14738 Manchester Rd
Suite B
Ballwin, MO 63011-3706
Phone (636) 227-2552

Other names 1

  • Ballwin Dental Care Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Ballwin Dental Care2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

14738 Manchester Rd
#B
Ballwin, MO 63011
Phone (636) 227-2552

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1422921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1422921600000",
    "number": "1972993541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14738 MANCHESTER RD",
            "address_2": "SUITE B",
            "city": "BALLWIN",
            "state": "MO",
            "postal_code": "630113706",
            "telephone_number": "636-227-2552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14738 MANCHESTER RD",
            "address_2": "SUITE B",
            "city": "BALLWIN",
            "state": "MO",
            "postal_code": "630113706",
            "telephone_number": "636-227-2552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIMBERLY D SIMONDS DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-03",
        "last_updated": "2015-02-03",
        "status": "A",
        "authorized_official_last_name": "SIMONDS",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "DAWN",
        "authorized_official_title_or_position": "DENTIST OWNER",
        "authorized_official_telephone_number": "636-227-2552",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "MO",
            "license": "016003",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ballwin Dental Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ballwin, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2015; 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.