Samuel P Weiner, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

2901007772 Issued in MI

Practice address

69089 N Main St
Richmond, MI 48062-1146

Phone

(586) 727-5865

Fax

(586) 727-8429

NPI assigned

Dec 14, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

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.

• Richmond-Dental Associates

  • General Practice Dentistry
  • Richmond, MI
  • NPI 1396807582
  NPD (past) Authorized official

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

{
    "created_epoch": "1166054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1326100611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8547 HENDRIE BLVD",
            "city": "HUNTINGTON WOODS",
            "state": "MI",
            "postal_code": "480701617",
            "telephone_number": "586-491-6482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "69089 N MAIN ST",
            "city": "RICHMOND",
            "state": "MI",
            "postal_code": "480621146",
            "telephone_number": "586-727-5865",
            "fax_number": "586-727-8429"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEINER",
        "first_name": "SAMUEL",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901007772",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PERMANENT DENTAL LIC.",
            "identifier": "2901007772",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3478902",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alyssa Taylor Walker
• Marilyn Ann Walker, LPC
• Melissa Kay Walker, LLPC
• Misty Weathington
• Eric Webster, CPRC
• Wellmetry Health, LLC
• Robert K. Wesley, D.D.S.
• Jade Whiting
• Joshua Wiitanen, PHARMD
• Tahson Winters, CCAR

• Dentist in Richmond, MI
• Providers in Richmond, MI by specialty
• Dentist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.