Active NPI
Jeena Samuel, D.M.D
- Dentist
- Stafford, TX
National Provider Identifier
1689853517
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 22166
- Practice address
- 738 FM 1092 Rd
Stafford, TX 77477-5910 - Phone
- (281) 969-8656
- Fax
- (281) 969-7998
- NPI assigned
- Oct 27, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 22166 | TX | Primary |
Addresses
Primary practice location
738 FM 1092 Rd
Stafford, TX 77477-5910
Mailing address
738 FM 1092 Rd
Stafford, TX 77477-5910
Phone (281) 969-8656
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
| License | State | Type | Specialty |
|---|---|---|---|
| 22166 | TX | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1193443200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1711324800000",
"number": "1689853517",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "738 FM 1092 RD",
"city": "STAFFORD",
"state": "TX",
"postal_code": "774775910",
"telephone_number": "281-969-8656",
"fax_number": "281-969-7998"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "738 FM 1092 RD",
"city": "STAFFORD",
"state": "TX",
"postal_code": "774775910",
"telephone_number": "281-969-8656",
"fax_number": "281-969-7998"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SAMUEL",
"first_name": "JEENA",
"name_prefix": "Dr.",
"credential": "D.M.D",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-10-27",
"last_updated": "2024-03-25",
"certification_date": "2024-03-25",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "TX",
"license": "22166",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Stafford, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 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.