NPIMap

Individual provider Active NPI

Farshad Samadnejad, DDS

  • Dentist
  • Rockville, MD
National Provider Identifier
1356775613
Registry record updated Aug 22, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
0401414153 Issued in VA
Practice address
5405 Tuckerman LN
Apt. # 453
Rockville, MD 20852-7301
Phone
(410) 530-1522
NPI assigned
Aug 22, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 22, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 15535 MD
Dentist 122300000X 0401414153 VA Primary

Addresses

Primary practice location

5405 Tuckerman LN
Apt. # 453
Rockville, MD 20852-7301

Mailing address

5405 Tuckerman LN
Apt. # 453
Rockville, MD 20852-7301
Phone (410) 530-1522

Other names 1

  • Shawn Samad Professional name

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
0401414153VAMDDentist
15535MDMDSports Physical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1377129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377129600000",
    "number": "1356775613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5405 TUCKERMAN LN",
            "address_2": "APT. # 453",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208527301",
            "telephone_number": "410-530-1522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5405 TUCKERMAN LN",
            "address_2": "APT. # 453",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208527301",
            "telephone_number": "410-530-1522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMADNEJAD",
        "first_name": "FARSHAD",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-08-22",
        "last_updated": "2013-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MD",
            "license": "15535",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401414153",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHAWN",
            "last_name": "SAMAD",
            "credential": "DDS",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Rockville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2013; 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.