Active NPI
Samuel Paul Andrews, DMD
- Prosthodontics
- Wilkes Barre, PA
National Provider Identifier
1255102422
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prosthodontics
- License
- DS043334
- Practice address
- 87 E Main St
Wilkes Barre, PA 18705-2811 - Phone
- (570) 823-6080
- NPI assigned
- Jan 15, 2024
- Sex
- Male
- 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 | 063881 | NY | |
| Prosthodontics | 1223P0700X | DS043334 | PA | Primary |
Addresses
Primary practice location
87 E Main St
Wilkes Barre, PA 18705-2811
Mailing address
87 E Main St
Wilkes Barre, PA 18705-2811
Phone (570) 823-6080
Other practice location 1
1960 S Clinton Ave
Rochester, NY 14618-5620
Phone (585) 461-4459
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 |
|---|---|---|---|
| 019.033224 | IL | MD | Dentist |
Interoperability endpoints
- sandrews33560@mskcc.direct-ci.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1705276800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1788307200000",
"number": "1255102422",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "87 E MAIN ST",
"city": "WILKES BARRE",
"state": "PA",
"postal_code": "187052811",
"telephone_number": "570-823-6080"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "87 E MAIN ST",
"city": "WILKES BARRE",
"state": "PA",
"postal_code": "187052811",
"telephone_number": "570-823-6080"
}
],
"practiceLocations": [
{
"address_1": "1960 S Clinton Ave",
"address_purpose": "LOCATION",
"city": "Rochester",
"state": "NY",
"postal_code": "146185620",
"country_code": "US",
"telephone_number": "585-461-4459",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ANDREWS",
"first_name": "SAMUEL",
"middle_name": "PAUL",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2024-01-15",
"last_updated": "2026-09-02",
"certification_date": "2026-09-02",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NY",
"license": "063881",
"primary": false
},
{
"code": "1223P0700X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Dentist, Prosthodontics",
"state": "PA",
"license": "DS043334",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Wilkes Barre, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 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.