Individual provider Active NPI

Samantha Rae Champion

  • General Practice Dentistry
  • McAllen, TX
National Provider Identifier
1114588134
Registry record updated Jun 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
35237 Issued in TX
Practice address
800 E Dove Ave Ste C
McAllen, TX 78504-2263
Phone
(956) 661-1000
NPI assigned
Jun 21, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 21, 2019

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 35237 TX Primary

Addresses

Primary practice location

800 E Dove Ave Ste C
McAllen, TX 78504-2263

Mailing address

3004 Princeton Ave
McAllen, TX 78504-1977
Phone (956) 249-0364

Other practice location 1

709 E Harrison Ave
Harlingen, TX 78550-9151
Phone (956) 428-8081

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
35237TXMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Anna Maria Garcia Family Dentistry General Practice Past Accepting new patients
Lisa Gortari DDS PLLC Past Accepting new patients
South Texas Dentistry, PLLC General Practice Past Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1561075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561075200000",
    "number": "1114588134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3004 PRINCETON AVE",
            "city": "MCALLEN",
            "state": "TX",
            "postal_code": "785041977",
            "telephone_number": "956-249-0364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 E DOVE AVE STE C",
            "city": "MCALLEN",
            "state": "TX",
            "postal_code": "785042263",
            "telephone_number": "956-661-1000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "709 E Harrison Ave",
            "address_purpose": "LOCATION",
            "city": "Harlingen",
            "state": "TX",
            "postal_code": "785509151",
            "country_code": "US",
            "telephone_number": "956-428-8081",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHAMPION",
        "first_name": "SAMANTHA",
        "middle_name": "RAE",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-06-21",
        "last_updated": "2019-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "35237",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in McAllen, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2019; 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.