NPIMap

Organization Active NPI

Samuel Bartlett DDS, PLLC

  • Dental Clinic/Center
  • Winston Salem, NC
National Provider Identifier
1841806387
Registry record updated Sep 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
SAMUEL BARTLETT DDS, PLLC
Practice address
3309 Healy Dr Ste B
Winston Salem, NC 27103-1474
Phone
(366) 765-8847
NPI assigned
Sep 21, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2020

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

Authorized official

Name
Samuel BartlettNPI 1821447350
Title
Organizer/Member
Phone
(435) 553-5392

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

3309 Healy Dr Ste B
Winston Salem, NC 27103-1474

Mailing address

3309 Healy Dr Ste B
Winston Salem, NC 27103-1474
Phone (366) 765-8847

Other identifiers 1

IdentifierTypeStateIssuer
1821447350MedicaidNC

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1600646400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1600646400000",
    "number": "1841806387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3309 HEALY DR STE B",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271031474",
            "telephone_number": "366-765-8847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3309 HEALY DR STE B",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271031474",
            "telephone_number": "366-765-8847"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAMUEL BARTLETT DDS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-21",
        "last_updated": "2020-09-21",
        "certification_date": "2020-09-21",
        "status": "A",
        "authorized_official_last_name": "BARTLETT",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_title_or_position": "ORGANIZER/MEMBER",
        "authorized_official_telephone_number": "435-553-5392"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1821447350",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2020; 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.