Provider Demographics
NPI:1720873912
Name:SIMPLY SMILE FAMILY & COSMETIC DENTISTRY PLLC
Entity type:Organization
Organization Name:SIMPLY SMILE FAMILY & COSMETIC DENTISTRY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:AMBER
Authorized Official - Middle Name:ROBINSON
Authorized Official - Last Name:HOGAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:540-815-1553
Mailing Address - Street 1:204 RIVER DON
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23188-8421
Mailing Address - Country:US
Mailing Address - Phone:540-815-1553
Mailing Address - Fax:
Practice Address - Street 1:5215 MONTICELLO AVE STE 110
Practice Address - Street 2:
Practice Address - City:WILLIAMSBURG
Practice Address - State:VA
Practice Address - Zip Code:23188-8232
Practice Address - Country:US
Practice Address - Phone:757-276-3029
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-10
Last Update Date:2025-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental