Samantha Ting Guan

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

DS043509 Issued in PA

Practice address

6595C Roosevelt Blvd
Philadelphia, PA 19149-2918

Phone

(215) 743-3700

Fax

(215) 743-3715

NPI assigned

Apr 29, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

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

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

{
    "created_epoch": "1619654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720483200000",
    "number": "1811570658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 BEALE ST",
            "city": "QUINCY",
            "state": "MA",
            "postal_code": "021703228",
            "telephone_number": "857-756-0349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6595C ROOSEVELT BLVD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191492918",
            "telephone_number": "215-743-3700",
            "fax_number": "215-743-3715"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4400 Emile St # 3602",
            "address_purpose": "LOCATION",
            "city": "Omaha",
            "state": "NE",
            "postal_code": "681980600",
            "country_code": "US",
            "telephone_number": "402-559-6000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2301 E Allegheny Ave Ste 201",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191344427",
            "country_code": "US",
            "telephone_number": "215-282-8000 x5",
            "fax_number": "215-427-1782",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "805 Route 38",
            "address_purpose": "LOCATION",
            "city": "Cherry Hill",
            "state": "NJ",
            "postal_code": "080022850",
            "country_code": "US",
            "telephone_number": "856-281-7600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUAN",
        "first_name": "SAMANTHA",
        "middle_name": "TING",
        "name_prefix": "Miss",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-29",
        "last_updated": "2024-07-09",
        "certification_date": "2024-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NE",
            "license": "7714",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NJ",
            "license": "22DI03027500",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "PA",
            "license": "DS043509",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jieun Gu, M. A., LPC
• Liang Gu, MD
• Joseph P. Guagliardo, DO
• Guoqiang Guan, D.D.S.
• Lucy Shan Guan, MD
• Gustavo Soares Guandalini, M.D.
• Dehcontee Guar, CRNP
• Guaranteed Health Hospice PA LLC
• Michael Alexander Guardado-Montesino, MD
• Guardian Angel Home Care Agency

• Pediatric Dentistry in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Pediatric Dentistry in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2024; 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.