Provider Demographics
NPI:1578734182
Name:SIMONSEN, ANNE FITZGERALD (DMD)
Entity type:Individual
Prefix:DR
First Name:ANNE
Middle Name:FITZGERALD
Last Name:SIMONSEN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26335 CARMEL RANCHO BLVD STE 5
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:CA
Mailing Address - Zip Code:93923-8889
Mailing Address - Country:US
Mailing Address - Phone:831-622-7100
Mailing Address - Fax:
Practice Address - Street 1:26335 CARMEL RANCHO BLVD STE 5
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:CA
Practice Address - Zip Code:93923-8889
Practice Address - Country:US
Practice Address - Phone:831-622-7100
Practice Address - Fax:831-293-8643
Is Sole Proprietor?:No
Enumeration Date:2008-03-23
Last Update Date:2024-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADDS62302122300000X
NMDD2958122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist