Samantha Jean Sutton, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

2007017222 Issued in MO

Practice address

1303 State St
Mound City, MO 64470-1717

Phone

(660) 442-5464

NPI assigned

Jul 12, 2007

Last updated

Jul 5, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

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

State licenses

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.

• Area Community Health Emissaries, Inc.

  dba ACHE Dental

  • Public Health Dentistry
  • Anderson, MO
  • NPI 1386774412

  Dental Public Health

  NPD (past)

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

{
    "created_epoch": "1184198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688515200000",
    "number": "1548469398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "718 CHERRY ST",
            "city": "CHILLICOTHE",
            "state": "MO",
            "postal_code": "646012210",
            "telephone_number": "660-973-3615",
            "fax_number": "660-646-3907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1303 STATE ST",
            "city": "MOUND CITY",
            "state": "MO",
            "postal_code": "644701717",
            "telephone_number": "660-442-5464"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1631 Commercial St",
            "address_purpose": "LOCATION",
            "city": "Warsaw",
            "state": "MO",
            "postal_code": "653553060",
            "country_code": "US",
            "telephone_number": "660-224-0398",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "718 Cherry St",
            "address_purpose": "LOCATION",
            "city": "Chillicothe",
            "state": "MO",
            "postal_code": "646012210",
            "country_code": "US",
            "telephone_number": "660-646-3900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SUTTON",
        "first_name": "SAMANTHA",
        "middle_name": "JEAN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-12",
        "last_updated": "2023-07-05",
        "certification_date": "2023-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MO",
            "license": "2007017222",
            "primary": true
        },
        {
            "code": "1223D0001X",
            "taxonomy_group": "",
            "desc": "Dentist, Dental Public Health",
            "state": "MO",
            "license": "2007017222",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "2007017222",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Mound City, MO
• Providers in Mound City, MO by specialty
• Dentist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2023; 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.