Individual provider Active NPI

Samer Namoo, DDS

  • General Practice Dentistry
  • Spring Valley, CA
National Provider Identifier
1194108191
Registry record updated Jul 8, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
64546 Issued in CA
Practice address
10821 Via Timoteo
Spring Valley, CA 91978-1231
Phone
(619) 277-3903
Fax
(619) 295-2385
NPI assigned
Jul 8, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 64546 CA
General Practice Dentistry 1223G0001X 64546 CA Primary

Addresses

Primary practice location

10821 Via Timoteo
Spring Valley, CA 91978-1231

Mailing address

10821 Via Timoteo
Spring Valley, CA 91978-1231
Phone (619) 277-3903

Other names 1

  • Samir Namoo Former name

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
64546CAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1436313600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436313600000",
    "number": "1194108191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10821 VIA TIMOTEO",
            "city": "SPRING VALLEY",
            "state": "CA",
            "postal_code": "919781231",
            "telephone_number": "619-277-3903",
            "fax_number": "619-295-2385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10821 VIA TIMOTEO",
            "city": "SPRING VALLEY",
            "state": "CA",
            "postal_code": "919781231",
            "telephone_number": "619-277-3903",
            "fax_number": "619-295-2385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAMOO",
        "first_name": "SAMER",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-07-08",
        "last_updated": "2015-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "64546",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "64546",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SAMIR",
            "last_name": "NAMOO",
            "credential": "DDS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Spring Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2015; 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.