Provider Demographics
NPI:1699252783
Name:H. CLIFTON SIMMONS III, D.D.S.
Entity type:Organization
Organization Name:H. CLIFTON SIMMONS III, D.D.S.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HENRY
Authorized Official - Middle Name:CLIFTON
Authorized Official - Last Name:SIMMONS
Authorized Official - Suffix:III
Authorized Official - Credentials:DDS
Authorized Official - Phone:615-329-1854
Mailing Address - Street 1:1916 HAYES ST
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-2317
Mailing Address - Country:US
Mailing Address - Phone:615-329-1854
Mailing Address - Fax:615-329-1880
Practice Address - Street 1:1916 HAYES ST
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-2317
Practice Address - Country:US
Practice Address - Phone:615-329-1854
Practice Address - Fax:615-329-1880
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-23
Last Update Date:2018-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3219261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1629131859OtherNPI