Individual provider Active NPI

Samantha P Wolff, DDS

  • Dentist
  • Clementon, NJ
National Provider Identifier
1154718963
Registry record updated Jun 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DI026273 Issued in NJ
Practice address
250 Gibbsboro Rd
Clementon, NJ 08021-4130
Phone
(856) 783-3300
NPI assigned
Apr 20, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 058759 NY
Dentist 122300000X DI026273 NJ Primary

Addresses

Primary practice location

250 Gibbsboro Rd
Clementon, NJ 08021-4130

Mailing address

250 Gibbsboro Rd
Clementon, NJ 08021-4130
Phone (856) 783-3300

Other practice location 1

345 E 24th St
New York, NY 10010-4020
Phone (212) 998-9800

Other identifiers 1

IdentifierTypeStateIssuer
39OtherNJDENTIST

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
DI026273NJMDDentist
058759NYMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Dental of Clementon Dentist Current Accepting new patients

Locations

250 Gibbsboro Rd
Clementon, NJ 08021
Phone (856) 783-1222

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": "1429488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593216000000",
    "number": "1154718963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 GIBBSBORO RD",
            "city": "CLEMENTON",
            "state": "NJ",
            "postal_code": "080214130",
            "telephone_number": "856-783-3300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 GIBBSBORO RD",
            "city": "CLEMENTON",
            "state": "NJ",
            "postal_code": "080214130",
            "telephone_number": "856-783-3300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "345 E 24th St",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100104020",
            "country_code": "US",
            "telephone_number": "212-998-9800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WOLFF",
        "first_name": "SAMANTHA",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-20",
        "last_updated": "2020-06-27",
        "certification_date": "2020-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "058759",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NJ",
            "license": "DI026273",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTIST",
            "identifier": "39",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clementon, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2020; 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.