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Provider Information for 1568424786



JARED SCOTT SIMPSON DDS

Gender: MALE

Individual NPI: 1568424786

Calendar Last Updated: 2007-07-09

Details

Name Value
NPI 1568424786
Enumeration Date 2006-04-04
NPI Type 1 - Individual
Sole Proprietor NO
Status Active
Mailing Address 12301 CROWN CREST DR
BAKERSFIELD, CA 93311-8503
United States

Phone: 661-654-0243 | Fax: 661-632-2147
View Map External Link
Primary Practice Address 234 BAKER ST STE 6
BAKERSFIELD, CA 93305-5856
United States

Phone: 661-632-2144 | Fax: 661-632-2147
View Map External Link
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 122300000X - Dentist CA 54553
No 122300000X - Dentist AZ D6587
Other Identifiers
Issuer State Number
MEDICAID AZ 994617