Individual provider Active NPI

Samuel Nabil Gabriel, D.M.D

  • Dentist
  • Lynwood, CA
National Provider Identifier
1952717381
Registry record updated Jul 7, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
63345 Issued in CA
Practice address
9910 Long Beach Blvd
Lynwood, CA 90262-1561
Phone
(323) 563-8900
NPI assigned
Jul 7, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 63345 CA Primary

Addresses

Primary practice location

9910 Long Beach Blvd
Lynwood, CA 90262-1561

Mailing address

2269 23Rd St
Santa Monica, CA 90405-1725
Phone (310) 508-8385

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20190710000245 CA Practitioner - Oral SurgeryPractitioner - Dentist 5799010047

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Samuel Gabriel DMD, Inc Dentist CurrentSince Apr 1, 2020 Accepting new patients
N Ozder Dental Practice Inc PastSince Apr 7, 2019 Accepting new patients
West Coast Dental Past Accepting new patients

Locations

18506 Hawthorne Blvd
Torrance, CA 90504
Phone (310) 483-7779

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": "1404691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404691200000",
    "number": "1952717381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2269 23RD ST",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904051725",
            "telephone_number": "310-508-8385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9910 LONG BEACH BLVD",
            "city": "LYNWOOD",
            "state": "CA",
            "postal_code": "902621561",
            "telephone_number": "323-563-8900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GABRIEL",
        "first_name": "SAMUEL",
        "middle_name": "NABIL",
        "name_prefix": "Dr.",
        "credential": "D.M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-07-07",
        "last_updated": "2014-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "63345",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynwood, CA

Sources for this page

Verify at the official NPI Registry.