Provider Demographics
NPI:1639393127
Name:PAUL, SIMI (DDS)
Entity type:Individual
Prefix:DR
First Name:SIMI
Middle Name:
Last Name:PAUL
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4070 N BELT LINE RD
Mailing Address - Street 2:SUITE 134
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75038-5028
Mailing Address - Country:US
Mailing Address - Phone:972-255-3400
Mailing Address - Fax:972-255-4300
Practice Address - Street 1:4070 N BELT LINE RD
Practice Address - Street 2:SUITE 134
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75038-5028
Practice Address - Country:US
Practice Address - Phone:972-255-3400
Practice Address - Fax:972-255-4300
Is Sole Proprietor?:No
Enumeration Date:2007-04-13
Last Update Date:2011-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX230261223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice