Alan Lee Samuel, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

24852 Issued in CA

Practice address

615 Harris St
Eureka, CA 95503-4447

Phone

(707) 442-1754

Fax

(707) 442-1755

NPI assigned

Jan 25, 2007

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1169683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372118400000",
    "number": "1710033618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 36TH PL UNIT A",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908032635",
            "telephone_number": "707-834-4017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 HARRIS ST",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "955034447",
            "telephone_number": "707-442-1754",
            "fax_number": "707-442-1755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMUEL",
        "first_name": "ALAN",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-25",
        "last_updated": "2013-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "24852",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTAL LICSENS",
            "identifier": "24852",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Taevia Salazar Pettitt, MSW, PPSC
• Reda Salhi
• Justino Salvador, RPH
• Kelly Nicole Sams, RPH
• Phil A Sams
• San Francisco Vamc
• San Francisco Vamc
• Alia Allen San Giovanni
• Chere Lois Sanborn
• Brittany Michele Sanchez, LVN

• General Practice Dentistry in Eureka, CA
• Providers in Eureka, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2013; 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.