Active NPI
Samuel Skinner Upton, D.D.S
- Dentist
- Twin Falls, ID
National Provider Identifier
1376901785
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- D-5315
- Practice address
- 1411 Falls Ave E Ste 1000C
Twin Falls, ID 83301-3459 - Phone
- (208) 734-7415
- NPI assigned
- Feb 1, 2016
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | D-5315 | ID | Primary |
Addresses
Primary practice location
1411 Falls Ave E Ste 1000C
Twin Falls, ID 83301-3459
Mailing address
3610 W Huron River Dr
Ann Arbor, MI 48103-9489
Phone (734) 649-8690
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
| License | State | Type | Specialty |
|---|---|---|---|
| D-5315 | ID | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Shasta Community Health Center | Dentist | Past | Accepting new patients |
| Smiles 4 Kids Jerome PLLC | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Pediatric Dentistry
- Jerome, ID
- NPI 1811683097
-
- Dentist
- Redding, CA
- NPI 1538181557
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1454284800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1646265600000",
"number": "1376901785",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3610 W HURON RIVER DR",
"city": "ANN ARBOR",
"state": "MI",
"postal_code": "481039489",
"telephone_number": "734-649-8690"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1411 FALLS AVE E STE 1000C",
"city": "TWIN FALLS",
"state": "ID",
"postal_code": "833013459",
"telephone_number": "208-734-7415"
}
],
"practiceLocations": [],
"basic": {
"last_name": "UPTON",
"first_name": "SAMUEL",
"middle_name": "SKINNER",
"credential": "D.D.S",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-02-01",
"last_updated": "2022-03-03",
"certification_date": "2022-03-03",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "ID",
"license": "D-5315",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Twin Falls, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.