Samantha Rosenbloom, DMD
Individual provider Active NPI Dentist · Brattleboro, VT
NPI 1194549006 · NPPES record last updated Nov 8, 2024
Key facts
- NPI
- 1194549006
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 016.0134328 (VT)
- Practice address
- 999 Putney Rd
Brattleboro, VT 05301-5101 - Phone
- (802) 254-8322
- NPI assigned
- Nov 8, 2024
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 016.0134328 | VT | MD | Dentist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 016.0134328 | VT | Yes |
Addresses
Primary practice location
999 Putney Rd
Brattleboro, VT 05301-5101
Mailing address
PO Box 8065
Brattleboro, VT 05304-8065
Phone (802) 254-8322
Other providers in Brattleboro, VT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 8, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.