Individual provider Active NPI

Shemika L Sample, DDS

  • Dentist
  • Silver Spring, MD
National Provider Identifier
1194024869
Registry record updated Mar 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
17477 Issued in MD
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

Updated by the provider on Mar 28, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
0401414041VAMDDentist
17477MDMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew 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.

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.

Verify at the official NPI Registry.