Active NPI
Shemika L Sample, DDS
- Dentist
- Silver Spring, MD
National Provider Identifier
1194024869
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 17477
- Practice address
- 344 University Blvd W
Silver Spring, MD 20901-1948 - Phone
- (202) 483-8196
- NPI assigned
- Mar 21, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 17477 | MD | Primary |
| Dentist | 122300000X | 0401414041 | VA |
Addresses
Primary practice location
344 University Blvd W
Silver Spring, MD 20901-1948
Mailing address
6339 Allentown Rd Ste E
Camp Springs, MD 20748-2600
Phone (301) 449-2800
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
| License | State | Type | Specialty |
|---|---|---|---|
| 0401414041 | VA | MD | Dentist |
| 17477 | MD | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| SL Sample DDS LLC | Current | Accepting new patients | |
| SL Sample, DDS LLC | Current | Accepting new patients | |
| C Benson Clark, DDS, PC | Past | Accepting new patients |
Locations
6339 Allentown Rd
Ste E
Temple Hills, MD 20748
Phone (301) 449-2800
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.
-
- Dental Clinic/Center
- Camp Springs, MD
- NPI 1164156972
-
- Dental Clinic/Center
- Camp Springs, MD
- NPI 1770200883
-
- General Practice Dentistry
- Alexandria, VA
- NPI 1134503444
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1300665600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1679961600000",
"number": "1194024869",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6339 ALLENTOWN RD STE E",
"city": "CAMP SPRINGS",
"state": "MD",
"postal_code": "207482600",
"telephone_number": "301-449-2800",
"fax_number": "301-449-2802"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "344 UNIVERSITY BLVD W",
"city": "SILVER SPRING",
"state": "MD",
"postal_code": "209011948",
"telephone_number": "202-483-8196"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SAMPLE",
"first_name": "SHEMIKA",
"middle_name": "L",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-03-21",
"last_updated": "2023-03-28",
"certification_date": "2023-03-28",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MD",
"license": "17477",
"primary": true
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "VA",
"license": "0401414041",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Silver Spring, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.