Benjamin Samardak

Primary specialty

DentistTaxonomy code 122300000X

License

DN122605 Issued in GA

Practice address

3455 Lawrenceville Hwy # 30044
Lawrenceville, GA 30044-4101

Phone

(770) 921-1115

NPI assigned

Sep 13, 2021

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.

• Gwinnett Family Dental Care

  • Dentist
  • Lawrenceville, GA
  • NPI 1316112360
  NPD (past)
• MVHS Inc

  • Community/Retail Pharmacy
  • Utica, NY
  • NPI 1306573753
  NPD (past)
• MVHS Inc

  • Family Medicine Physician
  • Utica, NY
  • NPI 1770690737
  NPD (past)

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

{
    "created_epoch": "1631491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674518400000",
    "number": "1801565718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1660 PEACHTREE ST NW",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303092470",
            "telephone_number": "585-689-0786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3455 LAWRENCEVILLE HWY # 30044",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300444101",
            "telephone_number": "770-921-1115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMARDAK",
        "first_name": "BENJAMIN",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-09-13",
        "last_updated": "2023-01-24",
        "certification_date": "2023-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "GA",
            "license": "DN122605",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephen Salvatore Salmieri, D.O.
• Anuj Kumar Saluja, DO
• Salveo Integrative Health
• Salveo Staffing Solutions
• Madhurika Samakur, D.O.
• Nsansa Sambo
• Afua Ataa Sampson, PMHNP
• Terri Peterson Sampson, LPC
• Samuel Bridge Solutions Inc
• Samuel Deutsch MD PC

• Dentist in Lawrenceville, GA
• Providers in Lawrenceville, GA by specialty
• Dentist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2023; 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.