Samuel Bobek PLLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

SAMUEL BOBEK PLLC

Practice address

600 Broadway Ste 460
Seattle, WA 98122-5312

Phone

(206) 320-2078

NPI assigned

Oct 25, 2019

Organization subpart

No

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

Authorized official

Name

Samuel Bobek, DMD, MD

Title

Owner

Phone

(503) 475-4735

Specialties & licenses 3

Addresses

Other names 1

• Seattle Jaw Surgery Doing business as

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 1

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

• Andrea Alys Burgess, PA-C

  • Surgical Physician Assistant
  • Seattle, WA
  • NPI 1831557107
  NPD (past)

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

{
    "created_epoch": "1571961600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1572220800000",
    "number": "1841833431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 BROADWAY STE 460",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981225312",
            "telephone_number": "206-320-2078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 BROADWAY STE 460",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981225312",
            "telephone_number": "206-320-2078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAMUEL BOBEK PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-25",
        "last_updated": "2019-10-28",
        "status": "A",
        "authorized_official_last_name": "BOBEK",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-475-4735",
        "authorized_official_credential": "DMD, MD"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Seattle Jaw Surgery",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Seattle Jaw Surgery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Navpreet Kaur Samra, PHARMD
• Navsumeet Samra
• Pavanjot Samra
• Annie Nithya Samraj, MD
• Michael Joseph Samsel, LMHC
• Ashante Samuels
• Jessica Samuels
• Melissa Samuels
• Valerie Samuels
• Paul Carter Samuelson, ARNP

• Dental Clinic/Center in Seattle, WA
• Providers in Seattle, WA by specialty
• Dental Clinic/Center in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.