Individual provider Active NPI

Joachim A Samano, D.D.S.

  • Dentist
  • League City, TX
National Provider Identifier
1124472022
Registry record updated Feb 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
32820 Issued in TX
Practice address
303 Magnolia Estates Dr
League City, TX 77573-4639
Phone
(972) 746-1338
NPI assigned
Apr 17, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 32820 TX Primary

Addresses

Primary practice location

303 Magnolia Estates Dr
League City, TX 77573-4639

Mailing address

303 Magnolia Estates Dr
League City, TX 77573-4639
Phone (972) 746-1338

Other practice location 1

305 W 12th Ave
Columbus, OH 43210-1267
Phone (614) 292-2622

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20160829001178 OH Order and Referring Only - DentistPractitioner - Dentist 6709171861

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
32820TXMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Tilger Center for Dentistry, PA Current Accepting new patients

Organizations & group practices 1

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": "1460851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519689600000",
    "number": "1124472022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 MAGNOLIA ESTATES DR",
            "city": "LEAGUE CITY",
            "state": "TX",
            "postal_code": "775734639",
            "telephone_number": "972-746-1338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 MAGNOLIA ESTATES DR",
            "city": "LEAGUE CITY",
            "state": "TX",
            "postal_code": "775734639",
            "telephone_number": "972-746-1338"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "305 W 12th Ave",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432101267",
            "country_code": "US",
            "telephone_number": "614-292-2622",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SAMANO",
        "first_name": "JOACHIM",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-17",
        "last_updated": "2018-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "32820",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in League City, TX

Sources for this page

Verify at the official NPI Registry.