Dr. Samuel'S Dental Group, Inc.

Primary specialty

DentistTaxonomy code 122300000X

License

51299 Issued in CA

Legal business name

DR. SAMUEL'S DENTAL GROUP, INC.

Practice address

6860 Brockton Ave Ste 10
Riverside, CA 92506-3816

Phone

(951) 683-5225

NPI assigned

May 6, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Naveen Samuel, D.D.S.NPI 1881809093

Title

President

Phone

(909) 844-6866

Specialties & licenses 1

Addresses

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Naveen Vattepu Samuel, DDS

  • Dentist
  • Riverside, CA
  • NPI 1881809093
  NPD (past) Authorized official
• Helen Song, D.D.S.

  • General Practice Dentistry
  • Riverside, CA
  • NPI 1073764452
  NPD (past)

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

{
    "created_epoch": "1304640000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1304640000000",
    "number": "1679865778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "71949 HIGHWAY 111 STE 100",
            "city": "RANCHO MIRAGE",
            "state": "CA",
            "postal_code": "922704826",
            "telephone_number": "909-844-6866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6860 BROCKTON AVE STE 10",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925063816",
            "telephone_number": "951-683-5225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. SAMUEL'S DENTAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-06",
        "last_updated": "2011-05-06",
        "status": "A",
        "authorized_official_last_name": "SAMUEL",
        "authorized_official_first_name": "NAVEEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "909-844-6866",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "51299",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Riverside, CA
• Providers in Riverside, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2011; 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.