Samuel Ross Penland, D.M.D.

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

9170 Issued in NC

Practice address

430 W 20TH St Ste 7
Newton, NC 28658-3732

Phone

(828) 464-9220

Fax

(828) 464-9234

NPI assigned

Jun 12, 2009

Last updated

Sep 12, 2011By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1244764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1315785600000",
    "number": "1386871697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "430 WEST 20TH ST SUITE#7",
            "city": "NEWTON",
            "state": "NC",
            "postal_code": "286583732",
            "telephone_number": "828-464-9220",
            "fax_number": "828-464-9234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 W 20TH ST STE 7",
            "city": "NEWTON",
            "state": "NC",
            "postal_code": "286583732",
            "telephone_number": "828-464-9220",
            "fax_number": "828-464-9234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENLAND",
        "first_name": "SAMUEL",
        "middle_name": "ROSS",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-06-12",
        "last_updated": "2011-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NC",
            "license": "9170",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nidhi Devendrabhai Patel, AGACNP
• Shital S Patel, MD
• David Eric Peltzer, M.D.
• Julie Lail Peltzer, M.A., CCC-SLP
• Pendleton G Waldron DDS
• Leandro Pereira
• Clifton Wade Pernell
• Anthony Michael Philips, DO
• Piedmont Village at Newton
• Piedmont Village at Newton, Inc. (Piedmont Village at Newton)

• Pediatric Dentistry in Newton, NC
• Providers in Newton, NC by specialty
• Pediatric Dentistry in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2011; 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.