Samuel Li, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

010813 Issued in CT

Practice address

469 Buckland Rd
South Windsor, CT 06074

Phone

(860) 644-2136

NPI assigned

Jun 23, 2011

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Kids Dental Care Anesthesia, LLC

  • Anesthesiology Physician
  • Bristol, CT
  • NPI 1104172881
  NPD (past)
• Kids Dental Care, LLC

  • Pediatric Dentistry
  • Bristol, CT
  • NPI 1619171790

  General Practice

  NPD (past)

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

{
    "created_epoch": "1308787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531353600000",
    "number": "1275829681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "162 BEELZEBUB RD",
            "city": "SOUTH WINDSOR",
            "state": "CT",
            "postal_code": "060742279",
            "telephone_number": "917-723-0403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "469 BUCKLAND RD",
            "city": "SOUTH WINDSOR",
            "state": "CT",
            "postal_code": "06074",
            "telephone_number": "860-644-2136"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "733 Terryville Ave",
            "address_purpose": "LOCATION",
            "city": "Bristol",
            "state": "CT",
            "postal_code": "060104034",
            "country_code": "US",
            "telephone_number": "860-584-0441",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LI",
        "first_name": "SAMUEL",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-23",
        "last_updated": "2018-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CT",
            "license": "010813",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Beth A Lemek, PA-C
• Michelle Leone, MS, SLP-CCC
• Zachary Leone, PA-C
• Sarita J Lewis
• Tracy Marie Lewis, LCSW
• Linda S Mittenthal LCSW LLC
• Andrea Little, MD, MBA
• Raymond G London, MD
• Lydia Lormand, D.O.
• Julia Louis, CNM

• General Practice Dentistry in South Windsor, CT
• Providers in South Windsor, CT by specialty
• General Practice Dentistry in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2018; 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.