Individual provider Active NPI

Samuel Bo Rum Oh, DMD

  • Pediatric Dentistry
  • Prosper, TX
National Provider Identifier
1194105809
Registry record updated Sep 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
33165 Issued in TX
Practice address
3620 W 1St St Ste 40
Prosper, TX 75078-3493
Phone
(469) 519-9951
NPI assigned
Jun 8, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X 33165 TX Primary
Pediatric Dentistry 1223P0221X S6-153 NV

Addresses

Primary practice location

3620 W 1St St Ste 40
Prosper, TX 75078-3493

Mailing address

3620 W 1St St Ste 40
Prosper, TX 75078-3493
Phone (469) 519-9951

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
33165TXMDClinical Psychologist
S6-153NVMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Samuel Oh DMD PLLC Pediatric Dentistry CurrentSince Aug 1, 2020 Accepting new patients

Locations

3620 W 1st St
Ste 40
Prosper, TX 75078
Phone (469) 519-9951

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": "1433721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789084800000",
    "number": "1194105809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3620 W 1ST ST STE 40",
            "city": "PROSPER",
            "state": "TX",
            "postal_code": "750783493",
            "telephone_number": "469-519-9951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3620 W 1ST ST STE 40",
            "city": "PROSPER",
            "state": "TX",
            "postal_code": "750783493",
            "telephone_number": "469-519-9951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OH",
        "first_name": "SAMUEL",
        "middle_name": "BO RUM",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-08",
        "last_updated": "2026-09-11",
        "certification_date": "2026-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "TX",
            "license": "33165",
            "primary": true
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NV",
            "license": "S6-153",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Prosper, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2026; 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.