Samantha Jette DDS - Professional Corporation

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

SAMANTHA JETTE DDS - PROFESSIONAL CORPORATION

Doing business as

Bridgeport Family Dentistry

Practice address

103 Steele St
Bridgeport, WV 26330-1068

Phone

(304) 842-0441

NPI assigned

Feb 27, 2021

Organization subpart

No

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

Authorized official

Name

Dr. Samantha Jette, DDSNPI 1700254034

Title

President

Phone

(304) 282-1640

Specialties & licenses 1

Addresses

Other names 1

• Bridgeport Family Dentistry Doing business as

Tax ID family

Bridgeport Family Dentistry2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Samantha Jette DDS - Professional Corporation

  • General Practice Dentistry
  • Clarksburg, WV
  • NPI 1902666415
  NPD tax ID

Locations

Practitioners 1

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

• Samantha Jette, D.D.S.

  • Dentist
  • Bridgeport, WV
  • NPI 1700254034
  NPD Authorized official

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

{
    "created_epoch": "1614384000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1614384000000",
    "number": "1881288058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 STEELE ST",
            "city": "BRIDGEPORT",
            "state": "WV",
            "postal_code": "263301068",
            "telephone_number": "304-842-0441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 STEELE ST",
            "city": "BRIDGEPORT",
            "state": "WV",
            "postal_code": "263301068",
            "telephone_number": "304-842-0441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAMANTHA JETTE DDS - PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-27",
        "last_updated": "2021-02-27",
        "certification_date": "2021-02-27",
        "status": "A",
        "authorized_official_last_name": "JETTE",
        "authorized_official_first_name": "SAMANTHA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "304-282-1640",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bridgeport Family Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Annas Sabbagh, DO
• Justin T Sage, MSW
• Muhammad Salman, M.D
• Logan Elizabeth Salyers, DO
• Mason Salyers
• Folusade Samuel, MD
• Lawren Elizabeth Sandy, MPT
• Allen George Saoud, DO
• April Sue Sauerwein
• Christopher J Saunders, CRNA

• Dental Clinic/Center in Bridgeport, WV
• Providers in Bridgeport, WV by specialty
• Dental Clinic/Center in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2021; 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.