Individual provider Active NPI

Samer G. Shamoon, D.D.S.

  • Dentist
  • Berkley, MI
National Provider Identifier
1770535981
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
14187 Issued in MI
Practice address
600 W 11 Mile Rd
Berkley, MI 48072-3027
Phone
(248) 543-1778
Fax
(248) 543-4245
NPI assigned
May 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 14187 MI Primary

Addresses

Primary practice location

600 W 11 Mile Rd
Berkley, MI 48072-3027

Mailing address

600 W 11 Mile Rd
Berkley, MI 48072-3027
Phone (248) 543-1778

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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

Enrollment IDStateProvider typePAC IDDetails
I20150519002186 MI Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 7517287345

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
14187MIMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Samer G. Shamoon, DDS, PC Current Accepting new patients

Locations

600 W 11 Mile Rd
Berkley, MI 48072
Phone (248) 543-1778

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1147737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1770535981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 W 11 MILE RD",
            "city": "BERKLEY",
            "state": "MI",
            "postal_code": "480723027",
            "telephone_number": "248-543-1778",
            "fax_number": "248-543-4245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 W 11 MILE RD",
            "city": "BERKLEY",
            "state": "MI",
            "postal_code": "480723027",
            "telephone_number": "248-543-1778",
            "fax_number": "248-543-4245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAMOON",
        "first_name": "SAMER",
        "middle_name": "G.",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-16",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "14187",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berkley, MI

Sources for this page

Verify at the official NPI Registry.