Individual provider Active NPI

Samuel Paul Andrews, DMD

  • Prosthodontics
  • Wilkes Barre, PA
National Provider Identifier
1255102422
Registry record updated Sep 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
ProsthodonticsTaxonomy code 1223P0700X
License
DS043334 Issued in PA
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

Updated by the provider on Sep 2, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 063881 NY
ProsthodonticsGroup: 193400000X SINGLE SPECIALTY GROUP 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

LicenseStateTypeSpecialty
019.033224ILMDDentist

Interoperability endpoints

  • Direct secure messaging: 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.

Verify at the official NPI Registry.