Individual provider Active NPI

Samuel Dantinne, OD

  • Optometrist
  • Denver, CO
National Provider Identifier
1821893900
Registry record updated Jun 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
0004117 Issued in CO
Practice address
7305 E 35TH Ave
Denver, CO 80238-2465
Phone
(303) 320-0022
NPI assigned
Feb 13, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 0004117 CO Primary

Addresses

Primary practice location

7305 E 35TH Ave
Denver, CO 80238-2465

Mailing address

620 Boston Ave Ste 6F
Medford, MA 02155-1372
Phone (414) 380-2597

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20250702002373 CO Practitioner - Optometry 9537672464 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
New England College of Optometry, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kerry K. Jarvis O.D. PLLCGroup PAC ID 7315379609, 3 clinicians

Practice addresses (Care Compare)

550 S Wadsworth Blvd
Unit 415
Lakewood, CO 80226-3128
Phone (303) 989-2020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0004117COMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Sowash Optometry Group, PC Optometrist CurrentSince Jul 1, 2025 Accepting new patients
Sowash Optometry Group PC Optometrist CurrentSince Jul 1, 2025 Accepting new patients
Kerry K Jarvis OD PLLC Optometrist CurrentSince Sep 23, 2025 Accepting new patients

Locations

550 S Wadsworth Blvd
Unit 415
Lakewood, CO 80226
Phone (303) 989-2020

4206 N Freeway Rd
Pueblo, CO 81008
Phone (719) 253-2538

Organizations & group practices 3

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": "1739404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749600000000",
    "number": "1821893900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 BOSTON AVE STE 6F",
            "city": "MEDFORD",
            "state": "MA",
            "postal_code": "021551372",
            "telephone_number": "414-380-2597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7305 E 35TH AVE",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802382465",
            "telephone_number": "303-320-0022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANTINNE",
        "first_name": "SAMUEL",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-02-13",
        "last_updated": "2025-06-11",
        "certification_date": "2025-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CO",
            "license": "0004117",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

Verify at the official NPI Registry.