Samuel Cassani, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

109080 Issued in CA

Practice address

3050 E 16TH St
Oakland, CA 94601-2319

Phone

(925) 363-2000

NPI assigned

Sep 5, 2023

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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 and National Provider Directory roles.

• La Clinica de la Raza Inc

  • Federally Qualified Health Center (FQHC)
  • Oakland, CA
  • NPI 1346262292
  NPD (past)

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

{
    "created_epoch": "1693872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693872000000",
    "number": "1699551747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3905 HIGH ST",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946192211",
            "telephone_number": "801-708-3598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3050 E 16TH ST",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946012319",
            "telephone_number": "925-363-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "22110 Montgomery St",
            "address_purpose": "LOCATION",
            "city": "Hayward",
            "state": "CA",
            "postal_code": "945413940",
            "country_code": "US",
            "telephone_number": "650-773-0333",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CASSANI",
        "first_name": "SAMUEL",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-09-05",
        "last_updated": "2023-09-05",
        "certification_date": "2023-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "109080",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Antonio Casillas, MA
• Arturo Alejandro Casillas
• Ivis Casillas
• Juan Casillas Jr., NP
• Victoria Davina Casillas
• Kasey Cassano
• Catherine S Cassel, M.S.W., L.C.S.W.
• Kortland Casselberry, DO
• Charna Cassell, LMFT
• Angelique Cassidy-Borst, MA, LMFT

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

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