Provider Demographics
NPI:1609925197
Name:SIMCOCK, RICHARD M (DDS)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:M
Last Name:SIMCOCK
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2219 RIMLAND DR., SUITE 403
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98226
Mailing Address - Country:US
Mailing Address - Phone:360-966-8354
Mailing Address - Fax:360-603-9445
Practice Address - Street 1:2219 RIMLAND DR., SUITE 403
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98226
Practice Address - Country:US
Practice Address - Phone:360-966-8354
Practice Address - Fax:360-603-9445
Is Sole Proprietor?:No
Enumeration Date:2007-01-10
Last Update Date:2021-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE83891223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics
Provider Identifiers
StateIdentifier IDID TypeIssuer
WADE8389OtherLICENSE NUMBER