Douglas Bryan Sam, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

40009 Issued in CA

Practice address

4519 Admiralty Way Ste 120
Marina del Rey, CA 90292-5455

Phone

(310) 821-5288

Fax

(310) 821-0153

NPI assigned

May 13, 2008

Sex

Male

Sole proprietor

No

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": "1210636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210636800000",
    "number": "1467629949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4519 ADMIRALTY WAY STE 120",
            "city": "MARINA DEL REY",
            "state": "CA",
            "postal_code": "902925455",
            "telephone_number": "310-821-5288",
            "fax_number": "310-821-0153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4519 ADMIRALTY WAY STE 120",
            "city": "MARINA DEL REY",
            "state": "CA",
            "postal_code": "902925455",
            "telephone_number": "310-821-5288",
            "fax_number": "310-821-0153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAM",
        "first_name": "DOUGLAS",
        "middle_name": "BRYAN",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-13",
        "last_updated": "2008-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "40009",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Danielle Diane Sager, D.C.
• Kenneth H. Sakurai, D.D.S.
• Seroos Salavati, M.D.
• Marla Salazar
• Wendy J. Salz, MFT
• Marjan Samiei, RPH
• Shauna Joyce Samuel
• Henry Sanchez
• Helen Marie Sanderson, D.D.S.
• Sandra Dawson, Ma, MFT, Marriage & Family Counseling, Apc

• General Practice Dentistry in Marina del Rey, CA
• Providers in Marina del Rey, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2008; 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.