Andrew Richard Samuel, D.M.D.

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

22DI01937000 Issued in NJ

Practice address

1300 State Route 35
Plaza 1, Suite 203
Ocean, NJ 07712-3537

Phone

(732) 517-9800

Fax

(732) 517-0319

NPI assigned

Oct 19, 2006

Sex

Male

Sole proprietor

Yes

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 NJ

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

Practice roles

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.

• Coastal Monmouth Dental Specialists, LLC

  dba Jersey Shore Endodontics

  • Endodontics
  • Ocean, NJ
  • NPI 1720696420
  NPD Authorized official

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1174605034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 STATE ROUTE 35",
            "address_2": "PLAZA 1, SUITE 203",
            "city": "OCEAN",
            "state": "NJ",
            "postal_code": "077123537",
            "telephone_number": "732-517-9800",
            "fax_number": "732-517-0319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 STATE ROUTE 35",
            "address_2": "PLAZA 1, SUITE 203",
            "city": "OCEAN",
            "state": "NJ",
            "postal_code": "077123537",
            "telephone_number": "732-517-9800",
            "fax_number": "732-517-0319"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMUEL",
        "first_name": "ANDREW",
        "middle_name": "RICHARD",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "NJ",
            "license": "22DI01937000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• S&J Ventures Inc (Reiters Pharmacy)
• Morgan Delaney Sabins
• Nicole Therese Saffioti, FNP-C
• Anthony Sallustio, DDS
• Adelaida Araceli Salmeron, LPC
• Sayali Maulik Sanghvi, DPT
• Barbara Paraskevi Sanoudis, D.C.
• Elias Sasson, MD
• Eric Sauer, R.PH.
• Liana M Savona, PA

• Periodontics in Ocean, NJ
• Providers in Ocean, NJ by specialty
• Periodontics in New Jersey

• 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.