Provider Demographics
NPI:1063409829
Name:SIMMONS, HOWARD STEVEN (DMD)
Entity type:Individual
Prefix:DR
First Name:HOWARD
Middle Name:STEVEN
Last Name:SIMMONS
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:82 STONEHURST LN
Mailing Address - Street 2:
Mailing Address - City:DIX HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11746-7934
Mailing Address - Country:US
Mailing Address - Phone:631-462-5144
Mailing Address - Fax:
Practice Address - Street 1:13 LINCOLN RD
Practice Address - Street 2:
Practice Address - City:FRANKLIN SQUARE
Practice Address - State:NY
Practice Address - Zip Code:11010-3616
Practice Address - Country:US
Practice Address - Phone:516-437-1240
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-05
Last Update Date:2014-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0304681223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice