Ed Samra, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

B41335 Issued in CA

Practice address

800 Corporate Dr
Suite 200
Ladera Ranch, CA 92694-1152

Phone

(949) 364-0006

Fax

(949) 364-0007

NPI assigned

Aug 30, 2007

Last updated

May 25, 2010By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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

Medicare enrollment (NPD)

Enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: esamra@direct.westerndental.com

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

{
    "created_epoch": "1188432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1274745600000",
    "number": "1023202264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 CORPORATE DR",
            "address_2": "SUITE 200",
            "city": "LADERA RANCH",
            "state": "CA",
            "postal_code": "926941152",
            "telephone_number": "949-364-0006",
            "fax_number": "949-364-0007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 CORPORATE DR",
            "address_2": "SUITE 200",
            "city": "LADERA RANCH",
            "state": "CA",
            "postal_code": "926941152",
            "telephone_number": "949-364-0006",
            "fax_number": "949-364-0007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMRA",
        "first_name": "ED",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-30",
        "last_updated": "2010-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "B41335",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Salvina Terese Rondoni, LPCC
• Ross Medical Associates Ladera
• Gina Lynn Ross, PTA
• Tina Rossi
• Hilla Sadri, M.D.
• Saray Sanchez
• Quinci Sandler
• Nicolette Sandoval
• Godfrey Chan Say, PT, MPT, PMA-CPT
• Scott N Macadam Chiropractic Corporation

• General Practice Dentistry in Ladera Ranch, CA
• Providers in Ladera Ranch, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.