Allen Douglas Samuelson, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

6174 Issued in NC

Practice address

CB # 7450 101 Brauer Hall
Chapel Hill, NC 27599-0001

Phone

(919) 966-1221

NPI assigned

Oct 20, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

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

Locations

Interoperability endpoints

• Direct secure messaging: asamuelson31201@direct.unc.nchie.net

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.

• University of North Carolina Hospitals at Chapel Hill

  • Interventional Cardiology Physician
  • Chapel Hill, NC
  • NPI 1568070308
  Medicare reassignment NPD
• University of North Carolina Hospitals at Chapel Hill

  • Community/Retail Pharmacy
  • Morrisville, NC
  • NPI 1134928542
  NPD
• University of North Carolina Hospitals at Chapel Hill

  • Transplant Surgery Physician
  • Chapel Hill, NC
  • NPI 1932745197
  NPD
• Dental Faculty Practice

  • Dentist
  • Chapel Hill, NC
  • NPI 1023044526

  General Practice

  NPD (past)
• Unc Oral & Maxillofacial Pathology Laboratory

  • Clinical Medical Laboratory
  • Chapel Hill, NC
  • NPI 1982632915
  NPD (past)
• University of North Carolina at Chapel Hill

  • Oral and Maxillofacial Surgery (Dentist)
  • Chapel Hill, NC
  • NPI 1790866564
  NPD (past)
• University of North Carolina Hospitals at Chapel Hill

  • Pediatric Nutrition Registered Dietitian
  • Chapel Hill, NC
  • NPI 1861415804
  NPD (past)

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

{
    "created_epoch": "1161302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440979200000",
    "number": "1750463345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 MANNING DRIVE",
            "address_2": "CB 7450",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275144220",
            "telephone_number": "919-537-3866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CB # 7450 101 BRAUER HALL",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275990001",
            "telephone_number": "919-966-1221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMUELSON",
        "first_name": "ALLEN",
        "middle_name": "DOUGLAS",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-20",
        "last_updated": "2015-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "6174",
            "primary": true
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NC",
            "license": "6174",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "91934",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8997572",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sonja Samant, MD
• Ahmad Salah Sami, MD
• Ashwath Jonathan Sampath, MD
• Amani Sampson
• Lattice Sams
• David Barrow Samuelson, D.D.S.
• Tamara Campbell Samuelson, D.M.D
• Teresa Danielle Samulski, MD
• Diana Monserrat Sanchez Amado
• Jennifer Thomas Sandbulte, MD

• General Practice Dentistry in Chapel Hill, NC
• Providers in Chapel Hill, NC by specialty
• General Practice Dentistry in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2015; 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.