Samuel James Ta Jr., DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

8973 Issued in SC

Practice address

1519 Heritage LN
Florence, SC 29505-3141

Phone

(843) 664-8777

NPI assigned

Jul 7, 2017

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Miller Dental Sleep LLC

  • General Practice Dentistry
  • Florence, SC
  • NPI 1316484306
  NPD (past)
• Miller Family & Cosmetic Dentistry, LLC

  • Dentist
  • Florence, SC
  • NPI 1366579070

  Single Specialty

  NPD (past)

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

{
    "created_epoch": "1499385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1499385600000",
    "number": "1740702091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2354 FREEDOM BLVD APT C8",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295056092",
            "telephone_number": "215-478-1659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1519 HERITAGE LN",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295053141",
            "telephone_number": "843-664-8777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TA",
        "first_name": "SAMUEL",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-07-07",
        "last_updated": "2017-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "SC",
            "license": "8973",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marcus N Swinton, MA
• Shugoofta Syed
• Solon R Symeonidis, RPH
• Brittany N. Syner, PA-C
• T Rhett Spencer Jr MD Services
• Josephine Anna Tai, DO
• Andrei Talantov, MD
• Philipp Eichler Talley Jr., DO
• Tyra Talley, PT
• Sherry S Tanner, RN

• General Practice Dentistry in Florence, SC
• Providers in Florence, SC by specialty
• General Practice Dentistry in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2017; 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.