Samuel Dastrup DDS PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

SAMUEL DASTRUP DDS PLLC

Practice address

430 S Salisbury Ave
Spencer, NC 28159-2239

Phone

(704) 633-1260

Fax

(704) 633-1263

NPI assigned

Jan 5, 2026

Last updated

Jan 5, 2026By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Samuel Dastrup, DDSNPI 1457911513

Title

Owner/Dentist

Phone

(801) 821-8982

Specialties & licenses 1

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Samuel Dastrup

  • Dentist
  • Spencer, NC
  • NPI 1457911513
  NPD Authorized official
• Kenneth Washko, DDS

  • Dentist
  • Spencer, NC
  • NPI 1700902780
  NPD (past)

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

{
    "created_epoch": "1767571200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1767571200000",
    "number": "1902763840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 113",
            "city": "SPENCER",
            "state": "NC",
            "postal_code": "281590113",
            "telephone_number": "435-671-8491",
            "fax_number": "704-633-1263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 S SALISBURY AVE",
            "city": "SPENCER",
            "state": "NC",
            "postal_code": "281592239",
            "telephone_number": "704-633-1260",
            "fax_number": "704-633-1263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAMUEL DASTRUP DDS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-01-05",
        "last_updated": "2026-01-05",
        "certification_date": "2026-01-05",
        "status": "A",
        "authorized_official_last_name": "DASTRUP",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "801-821-8982",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Elizabeth Denise Reynolds, DPT
• Rowan Diagnostic Clinic (Spencer Family Medicine)
• Holly Anne Smith, M.S., R.D., L.D.
• Sonshine Community Outreach Services
• Diane Spicer, OTR
• St. Michael's Therapeutic Services, Inc
• Melinda Marie Steelman, COTA

• General Practice Dentistry in Spencer, NC
• Providers in Spencer, NC by specialty
• General Practice Dentistry in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2026; 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.