Samuel John Deangelo, DDS

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

7596 Issued in NC

Practice address

1142 Executive Circle
Suite B
Cary, NC 27518

Phone

(919) 467-3213

Fax

(919) 467-3246

NPI assigned

Jul 3, 2007

Sex

Male

Sole proprietor

No

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 NC

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.

• Samuel J. Deangelo

  • Dental Clinic/Center
  • Cary, NC
  • NPI 1700043148
  NPD (past) Authorized official

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

{
    "created_epoch": "1183420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750723200000",
    "number": "1740488501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1142 EXECUTIVE CIRCLE",
            "address_2": "SUITE B",
            "city": "CARY",
            "state": "NC",
            "postal_code": "27518",
            "telephone_number": "919-467-3213",
            "fax_number": "919-467-3246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1142 EXECUTIVE CIRCLE",
            "address_2": "SUITE B",
            "city": "CARY",
            "state": "NC",
            "postal_code": "27518",
            "telephone_number": "919-467-3213",
            "fax_number": "919-467-3246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEANGELO",
        "first_name": "SAMUEL",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-03",
        "last_updated": "2025-06-24",
        "certification_date": "2025-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "NC",
            "license": "7596",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tatiana De la Cruz Gonzalez
• Chris Mae Olis Deal
• Angel Dean-Moore, LPCA
• Amanda R Dean, MA
• Sarah Marie Deane
• Abby Grace Deans
• Ashley Nicole Dearcia Cota
• Lena Deas
• Eleanor Virginia Deberry
• Angelia Debono

• Periodontics in Cary, NC
• Providers in Cary, NC by specialty
• Periodontics in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2025; 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.