Individual provider Active NPI

Samar Al Quraishi

  • Dentist
  • Wynnewood, PA
National Provider Identifier
1497362982
Registry record updated Sep 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DS042925 Issued in PA
Practice address
625 E Lancaster Ave Apt C303
Wynnewood, PA 19096-2028
Phone
(619) 792-2297
NPI assigned
Sep 28, 2020
Last updated
Sep 28, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DS042925 PA Primary

Addresses

Primary practice location

625 E Lancaster Ave Apt C303
Wynnewood, PA 19096-2028

Mailing address

625 E Lancaster Ave Apt C303
Wynnewood, PA 19096-2028
Phone (619) 792-2297

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DS042925PAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1601251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601251200000",
    "number": "1497362982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 E LANCASTER AVE APT C303",
            "city": "WYNNEWOOD",
            "state": "PA",
            "postal_code": "190962028",
            "telephone_number": "619-792-2297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 E LANCASTER AVE APT C303",
            "city": "WYNNEWOOD",
            "state": "PA",
            "postal_code": "190962028",
            "telephone_number": "619-792-2297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AL QURAISHI",
        "first_name": "SAMAR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-28",
        "last_updated": "2020-09-28",
        "certification_date": "2020-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PA",
            "license": "DS042925",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wynnewood, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2020; 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.