Sumita Susan Sam, DDS

Primary specialty

Oral and Maxillofacial Pathology DentistryTaxonomy code 1223P0106X

License

DTP805 Issued in FL

Practice address

1395 Center Dr RM D8-6
Gainesville, FL 32610-3006

Phone

(352) 273-6703

NPI assigned

Jul 21, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Oral and Maxillofacial Pathology

Education

University of Detroit Mercy School of Dentistry, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Faculty Associates IncorporatedGroup PAC ID 4981707460, 16 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

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.

• Faculty Associates Incorporated

  • Dentist
  • Gainesville, FL
  • NPI 1255383550
  Medicare reassignment Care Compare group NPD
• Florida Clinical Practice Association Inc

  dba UF Health Physicians

  • Surgery Physician
  • Gainesville, FL
  • NPI 1063463768
  Medicare reassignment NPD
• Florida Clinical Practice Association Inc

  dba UF Health Family Medicine Ocala Heath Brook

  • Durable Medical Equipment & Medical Supplies
  • Ocala, FL
  • NPI 1609529478
  NPD

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

{
    "created_epoch": "1500595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709942400000",
    "number": "1326561200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 100414",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326100414",
            "telephone_number": "352-273-6695",
            "fax_number": "352-294-5310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1395 CENTER DR RM D8-6",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326103006",
            "telephone_number": "352-273-6703"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1600 SW Archer Rd",
            "address_purpose": "LOCATION",
            "city": "Gainesville",
            "state": "FL",
            "postal_code": "326103006",
            "country_code": "US",
            "telephone_number": "352-273-6695",
            "fax_number": "352-294-5310",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SAM",
        "first_name": "SUMITA",
        "middle_name": "SUSAN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-21",
        "last_updated": "2024-03-09",
        "certification_date": "2024-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "291022390",
            "primary": false
        },
        {
            "code": "1223P0106X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Pathology",
            "state": "FL",
            "license": "DTP805",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chloe Marie Salum
• Caitlin Mary-Alice Salvagno, AUD
• Sabrina Salvant
• Sushma Salwan, MD
• Diana Lynne Salzburg, LM
• Sam's Club Optical (Sam's Club Optical 30-8155)
• Saralakumari Ramadas Samakur, RD/LDN
• Samant Dental Group
• Paivi Samant, D.D.S.
• Samarkos and Rodriguez DMD PA (Tower Dental Associates)

• Oral and Maxillofacial Pathology Dentistry in Gainesville, FL
• Providers in Gainesville, FL by specialty
• Oral and Maxillofacial Pathology Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.