Provider Demographics
NPI:1427422765
Name:SIMS, STEPHEN CRAIG (DDS)
Entity type:Individual
Prefix:
First Name:STEPHEN
Middle Name:CRAIG
Last Name:SIMS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1725 CIMARRON TRAIL
Mailing Address - Street 2:SUITE 1
Mailing Address - City:HURST
Mailing Address - State:TX
Mailing Address - Zip Code:76054
Mailing Address - Country:US
Mailing Address - Phone:817-280-9300
Mailing Address - Fax:817-280-9296
Practice Address - Street 1:1725 CIMARRON TRAIL
Practice Address - Street 2:SUITE 1
Practice Address - City:HURST
Practice Address - State:TX
Practice Address - Zip Code:76054
Practice Address - Country:US
Practice Address - Phone:817-280-9300
Practice Address - Fax:817-280-9296
Is Sole Proprietor?:No
Enumeration Date:2015-11-24
Last Update Date:2015-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12069122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist