Shannon Sue Samuels Farmer, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Practice address

309 Hamilton St
Suite C
Geneva, IL 60134-2134

Phone

(630) 232-1111

Fax

(630) 232-1131

NPI assigned

Feb 16, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Shannon S Samuels Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1171584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1023152519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "735 HAWTHORNE LN",
            "city": "GENEVA",
            "state": "IL",
            "postal_code": "601343043",
            "telephone_number": "630-262-8218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "309 HAMILTON ST",
            "address_2": "SUITE C",
            "city": "GENEVA",
            "state": "IL",
            "postal_code": "601342134",
            "telephone_number": "630-232-1111",
            "fax_number": "630-232-1131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMUELS FARMER",
        "first_name": "SHANNON",
        "middle_name": "SUE",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHANNON",
            "last_name": "SAMUELS",
            "middle_name": "S",
            "prefix": "DR.",
            "credential": "D.D.S.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• General Practice Dentistry in Geneva, IL
• Providers in Geneva, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.