Individual provider Active NPI

Samuel Casco, DDS

  • Dentist
  • Rowlett, TX
National Provider Identifier
1629778485
Registry record updated Apr 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
39793 Issued in TX
Practice address
5701 President George Bush Hwy Ste 140
Rowlett, TX 75089-3694
Phone
(214) 703-0703
Fax
(214) 703-0702
NPI assigned
Mar 8, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Dentist 122300000X 39793 TX Primary

Addresses

Primary practice location

5701 President George Bush Hwy Ste 140
Rowlett, TX 75089-3694

Mailing address

3302 Gaston Ave
Dallas, TX 75246-2013
Phone (214) 828-8215

Other practice location 1

3607 Oak Lawn Ave Ste 250
Dallas, TX 75219-4788
Phone (214) 699-4976

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
39793TXMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Peppermint Dental Dentist CurrentSince Apr 28, 2024 Accepting new patients
McCauley Hometown Dental PLLC PastSince Dec 21, 2025 Accepting new patients
Dan P McCauley DDS PA PastSince Sep 1, 2023 Accepting new patients
Bleu Dentistry LLC PastSince Sep 13, 2019 Accepting new patients

Locations

5701 President George Bush Hwy
Ste 140
Rowlett, TX 75089
Phone (214) 703-0703

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1678233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713830400000",
    "number": "1629778485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3302 GASTON AVE",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752462013",
            "telephone_number": "214-828-8215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5701 PRESIDENT GEORGE BUSH HWY STE 140",
            "city": "ROWLETT",
            "state": "TX",
            "postal_code": "750893694",
            "telephone_number": "214-703-0703",
            "fax_number": "214-703-0702"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3607 Oak Lawn Ave Ste 250",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752194788",
            "country_code": "US",
            "telephone_number": "214-699-4976",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CASCO",
        "first_name": "SAMUEL",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-03-08",
        "last_updated": "2024-04-23",
        "certification_date": "2024-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "39793",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rowlett, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2024; 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.