Greg Samples, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

12044 Issued in GA

Practice address

1008 Druid Park Ave
Augusta, GA 30904-5848

Phone

(706) 733-7999

Fax

(706) 733-7343

NPI assigned

Jan 23, 2007

Last updated

Jul 8, 2007By 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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in GA

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

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1437203759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1008 DRUID PARK AVE",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309045848",
            "telephone_number": "706-733-7999",
            "fax_number": "706-733-7343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1008 DRUID PARK AVE",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309045848",
            "telephone_number": "706-733-7999",
            "fax_number": "706-733-7343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMPLES",
        "first_name": "GREG",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "12044",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZG2044",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Samaritian Care, LLC
• Fnu Samarta Alias Monika, M.D
• Nicholas Kento Sammond, DO
• Brittany Sammons
• Brianna Lynn Sample, DNP, FNP-BC
• Hasan Samra, M.D.
• Sams East Inc (Sams Pharmacy 10-8115)
• Anita Samuel
• Lynette Samuel
• Thinn Ei San, MD

• General Practice Dentistry in Augusta, GA
• Providers in Augusta, GA by specialty
• General Practice Dentistry in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.