Samer Mufid Othman, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN014686 Issued in GA

Practice address

4705 Northside Dr
Suite 100
Macon, GA 31210-1698

Phone

(478) 207-6939

NPI assigned

Jul 25, 2012

Last updated

Aug 28, 2014By the provider in NPPES

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

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

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Advanced Dental Arts, LLC

  • Dental Clinic/Center
  • Macon, GA
  • NPI 1679969380
  NPD (past) Authorized official

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

{
    "created_epoch": "1343174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409184000000",
    "number": "1497001630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4705 NORTHSIDE DR",
            "address_2": "SUITE 100",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312101698",
            "telephone_number": "478-207-6939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4705 NORTHSIDE DR",
            "address_2": "SUITE 100",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312101698",
            "telephone_number": "478-207-6939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OTHMAN",
        "first_name": "SAMER",
        "middle_name": "MUFID",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-25",
        "last_updated": "2014-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN014686",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kennedy Brooke Osborne
• Megan L Osborne, PA-C
• Ossp Imaging of Macon
• Richard David Oster, D.C.
• Otcwholesale LLC
• Douglas E Ott, MD
• Julie Faircloth Ott, FNP
• Whitnee Otto, MD
• Our Gift to You (Right at Home)
• Overflowing Health Behavioral LLC

• General Practice Dentistry in Macon, GA
• Providers in Macon, 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 Aug 28, 2014; 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.