Provider Demographics
NPI:1609941954
Name:SIMS, MICHAEL DAVID (DMD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:DAVID
Last Name:SIMS
Suffix:
Gender:M
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:VETERANS AFFAIRS, COPC
Mailing Address - Street 2:6401 SHALLOWFORD ROAD OFFICE: M 117
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37411
Mailing Address - Country:US
Mailing Address - Phone:423-893-6500
Mailing Address - Fax:
Practice Address - Street 1:VETERANS AFFAIRS, COPC
Practice Address - Street 2:6401 SHALLOWFORD ROAD
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37411
Practice Address - Country:US
Practice Address - Phone:423-893-6500
Practice Address - Fax:423-892-3785
Is Sole Proprietor?:No
Enumeration Date:2006-11-22
Last Update Date:2023-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL43291223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice