Blake Tyler Samper, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DGD.10806 Issued in SC

Practice address

5540 Sunset Blvd
Lexington, SC 29072-9262

Phone

(803) 358-8250

NPI assigned

Mar 6, 2024

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

Locations

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.

• Michael Jimenez DDS LLC

  • General Practice Dentistry
  • Lexington, SC
  • NPI 1831741396
  NPD

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

{
    "created_epoch": "1709683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717545600000",
    "number": "1316704208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11815 VANCE JACKSON RD APT 2401",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782301445",
            "telephone_number": "205-746-7318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5540 SUNSET BLVD",
            "city": "LEXINGTON",
            "state": "SC",
            "postal_code": "290729262",
            "telephone_number": "803-358-8250"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "368 Harbison Blvd Ste 201",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "SC",
            "postal_code": "292122248",
            "country_code": "US",
            "telephone_number": "803-234-2320",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SAMPER",
        "first_name": "BLAKE",
        "middle_name": "TYLER",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-03-06",
        "last_updated": "2024-06-05",
        "certification_date": "2024-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "SC",
            "license": "DGD.10806",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katrena Amber Saillant, BSN
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• Alison Holland Sallings, ACNP-BC
• Christina Janushevich Samela
• Kathryn Rogers Sample, DMD
• Chris A Sanchez
• William R. Sanders
• Sandhills Medical Foundation, Inc.
• Sandhills Pediatrics

• General Practice Dentistry in Lexington, SC
• Providers in Lexington, SC by specialty
• General Practice Dentistry in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2024; 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.