Active NPI
Elizabeth T Samuel, DMD
- Dentist
- Garland, TX
National Provider Identifier
1750456315
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 22120
- Practice address
- 1919 S Shiloh Rd Ste 400
Trophy Dental of Garland
Garland, TX 75042-8211 - Phone
- (972) 271-1581
- Fax
- (972) 272-3176
- NPI assigned
- Nov 21, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 22120 | TX | Primary |
Addresses
Primary practice location
1919 S Shiloh Rd Ste 400
Trophy Dental of Garland
Garland, TX 75042-8211
Mailing address
1919 S Shiloh Rd Ste 400
Garland, TX 75042-8211
Phone (972) 271-1581
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
| License | State | Type | Specialty |
|---|---|---|---|
| 22120 | TX | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164067200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1750456315",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1919 S SHILOH RD STE 400",
"city": "GARLAND",
"state": "TX",
"postal_code": "750428211",
"telephone_number": "972-271-1581",
"fax_number": "972-272-3176"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1919 S SHILOH RD STE 400",
"address_2": "TROPHY DENTAL OF GARLAND",
"city": "GARLAND",
"state": "TX",
"postal_code": "750428211",
"telephone_number": "972-271-1581",
"fax_number": "972-272-3176"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SAMUEL",
"first_name": "ELIZABETH",
"middle_name": "T",
"name_prefix": "Mrs.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-21",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "TX",
"license": "22120",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Garland, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.