Individual provider Active NPI

Samer Dar, DDS, MD

  • Oral and Maxillofacial Surgery (Dentist)
  • Houston, TX
National Provider Identifier
1477539435
Registry record updated Jul 14, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
21280 Issued in TX
Practice address
902 Frostwood Dr
Suite 227
Houston, TX 77024-2420
Phone
(713) 464-2792
Fax
(713) 464-4541
NPI assigned
Dec 21, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 14, 2010

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 053285 NY
Dentist 122300000X 21280 TX
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 21280 TX Primary

Addresses

Primary practice location

902 Frostwood Dr
Suite 227
Houston, TX 77024-2420

Mailing address

17107 Lapeer CT
Spring, TX 77379-3520
Phone (281) 376-2183

Other identifiers 1

IdentifierTypeStateIssuer
009327OtherCTSTATE LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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

Enrollment IDStateProvider typePAC IDDetails
I20171026002066 TX Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 6608142203

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
053285NYMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1135123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1279065600000",
    "number": "1477539435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17107 LAPEER CT",
            "city": "SPRING",
            "state": "TX",
            "postal_code": "773793520",
            "telephone_number": "281-376-2183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "902 FROSTWOOD DR",
            "address_2": "SUITE 227",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770242420",
            "telephone_number": "713-464-2792",
            "fax_number": "713-464-4541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAR",
        "first_name": "SAMER",
        "name_prefix": "Dr.",
        "credential": "DDS, MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-21",
        "last_updated": "2010-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "053285",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "21280",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "TX",
            "license": "21280",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "009327",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.