Samer Magdi Ebeid, D.D.S.

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

40428 Issued in CA

Practice address

750 Las Gallinas Ave Ste 108
San Rafael, CA 94903-3431

Phone

(415) 479-6444

Fax

(415) 479-2315

NPI assigned

Sep 25, 2006

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

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1114028222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 LAS GALLINAS AVE STE 108",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949033431",
            "telephone_number": "415-479-6444",
            "fax_number": "415-479-2315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 LAS GALLINAS AVE STE 108",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949033431",
            "telephone_number": "415-479-6444",
            "fax_number": "415-479-2315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EBEID",
        "first_name": "SAMER",
        "middle_name": "MAGDI",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "CA",
            "license": "40428",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susan Ann Dyer, PSY.D.
• Kathleen Ann Eagle, PSYD
• Kevin Michael Eagleson
• Eliscia Denise Easiley
• Anthony A. Eason, MD
• Laura Worth Eberhard, MD
• Wendy Eberhardt, MD
• Carin Ebey, M.S.
• Chinenye Echem
• Solange Echeverria

• Endodontics in San Rafael, CA
• Providers in San Rafael, CA by specialty
• Endodontics in California

• 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.
• 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.