Individual provider Active NPI

Sam J Citrano Jr., DMD

  • General Practice Dentistry
  • Huntsville, AL
National Provider Identifier
1003800046
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
4772 Issued in AL
Practice address
411 Holmes Ave NE
Suite a
Huntsville, AL 35801-4142
Phone
(256) 534-7692
Fax
(256) 534-7692
NPI assigned
Sep 6, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 4772 AL Primary

Addresses

Primary practice location

411 Holmes Ave NE
Suite a
Huntsville, AL 35801-4142

Mailing address

411 Holmes Ave NE
Suite a
Huntsville, AL 35801-4142
Phone (256) 534-7692

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150917001241 AL Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 1254648652

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4772ALMDGeneral Practice Dentistry

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1125964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1003800046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 HOLMES AVE NE",
            "address_2": "SUITE A",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358014142",
            "telephone_number": "256-534-7692",
            "fax_number": "256-534-7692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 HOLMES AVE NE",
            "address_2": "SUITE A",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358014142",
            "telephone_number": "256-534-7692",
            "fax_number": "256-534-7692"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CITRANO",
        "first_name": "SAM",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-06",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AL",
            "license": "4772",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntsville, AL

Sources for this page

Verify at the official NPI Registry.