NPIMap

Individual provider Active NPI

Samuel Campbell Jr., DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Indeanapolis, IN
National Provider Identifier
1700858701
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
12007499A Issued in IN
Practice address
8240 Naab Zal
Ste 355
Indeanapolis, IN 46260
Phone
(317) 876-1095
Fax
(317) 875-7275
NPI assigned
Feb 3, 2006
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 12007499A IN
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 12007499A IN Primary

Addresses

Primary practice location

8240 Naab Zal
Ste 355
Indeanapolis, IN 46260

Mailing address

7532 Sauterne CT
Indeanapolis, IN 46278
Phone (317) 872-5282

Other identifiers 1

IdentifierTypeStateIssuer
000000244574OtherINBLUE SHIELD ID

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
12007499AINMDOral and Maxillofacial Surgery (Dentist)

NPI Registry JSON

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

{
    "created_epoch": "1138924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1700858701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7532 SAUTERNE CT",
            "city": "INDEANAPOLIS",
            "state": "IN",
            "postal_code": "46278",
            "telephone_number": "317-872-5282",
            "fax_number": "317-875-7275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8240 NAAB ZAL",
            "address_2": "STE 355",
            "city": "INDEANAPOLIS",
            "state": "IN",
            "postal_code": "46260",
            "telephone_number": "317-876-1095",
            "fax_number": "317-875-7275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "SAMUEL",
        "name_suffix": "Jr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-03",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IN",
            "license": "12007499A",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "IN",
            "license": "12007499A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD ID",
            "identifier": "000000244574",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.