Sarah Samuel, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

20750 Issued in TX

Practice address

428 Centennial Pkwy
Tyler, TX 75703-7166

Phone

(903) 266-5900

NPI assigned

Oct 17, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Dallas Vamc

  • Department of Veterans Affairs (VA) Pharmacy
  • Tyler, TX
  • NPI 1942952072
  NPD

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

{
    "created_epoch": "1192579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661385600000",
    "number": "1689863441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "428 CENTENNIAL PKWY",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757037166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "428 CENTENNIAL PKWY",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757037166",
            "telephone_number": "903-266-5900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMUEL",
        "first_name": "SARAH",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-17",
        "last_updated": "2022-08-25",
        "certification_date": "2022-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "20750",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://www.va.gov/north-texas-health-care/locations/tyler-centennial-va-clinic/",
            "affiliation": "N",
            "address_1": "428 Centennial Pkwy",
            "city": "Tyler",
            "state": "TX",
            "country_code": "US",
            "postal_code": "757037166",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Sam'S Club Optical
• Syed Raheel Sameeruddin, M.D.
• Mohammad Samiullah, MD
• Kaitlin Samples
• Sams East Inc
• Blake Sanca, COTA
• Juan Carlos Sanchez Hernandez, SA-C
• Alejandro Sanchez
• Delsea-Rain Sanchez
• Farrar Sanchez

• All providers in Tyler, TX
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2022; 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.