Individual provider Active NPI

Sam T. Photopoulos, D.D.S.

  • General Practice Dentistry
  • San Jose, CA
National Provider Identifier
1346282753
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
27820 Issued in CA
Practice address
2005 Camden Ave
San Jose, CA 95124-2024
Phone
(408) 377-9091
Fax
(408) 377-9245
NPI assigned
Jun 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 27820 CA Primary

Addresses

Primary practice location

2005 Camden Ave
San Jose, CA 95124-2024

Mailing address

13774 Fortuna CT
Saratoga, CA 95070-5242
Phone (408) 867-2840

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
27820CAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1149984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1346282753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13774 FORTUNA CT",
            "city": "SARATOGA",
            "state": "CA",
            "postal_code": "950705242",
            "telephone_number": "408-867-2840",
            "fax_number": "408-377-9245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2005 CAMDEN AVE",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951242024",
            "telephone_number": "408-377-9091",
            "fax_number": "408-377-9245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHOTOPOULOS",
        "first_name": "SAM",
        "middle_name": "T.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-11",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "27820",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 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.