NPIMap

Individual provider Active NPI

Samir Waris, MD, DMD

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Phoenix, AZ
National Provider Identifier
1952748196
Registry record updated Aug 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X
License
74684 Issued in AZ
Practice address
2525 E Roosevelt St
Phoenix, AZ 85008-4948
Phone
(602) 344-1015
NPI assigned
May 29, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X D012389 AZ
Oral & Maxillofacial Surgery (D.M.D.) 204E00000X 74684 AZ Primary
Oral & Maxillofacial Surgery (D.M.D.) 204E00000X 62798 MN
Oral & Maxillofacial Surgery (D.M.D.) 204E00000X D13292 MN

Addresses

Primary practice location

2525 E Roosevelt St
Phoenix, AZ 85008-4948

Mailing address

2929 E Thomas Rd
Phoenix, AZ 85016-8034
Phone (602) 470-5000

Other practice location 1

415 Morris St Ste 309
Charleston, WV 25301-1853
Phone (304) 388-3290

Other practice location 2

200 1st St SW
Rochester, MN 55905-0001
Phone (507) 284-2511

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV, AZ2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20200701003215 WV Practitioner - Maxillofacial SurgeryPractitioner - Other (Physician)Practitioner - Oral Surgery 2466686712 Reassigns benefits to 1 organization
I20250219003451 AZ Practitioner - Maxillofacial SurgeryPractitioner - Dentist 2466686712 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Maxillofacial SurgeryAlso: Dentist
Education
Mayo Medical School, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
District Medical Group IncGroup PAC ID 7315086691, 454 clinicians

Practice addresses (Care Compare)

2601 E Roosevelt St
Phoenix, AZ 85008-4973
Phone (602) 344-5011

Hospital & facility affiliations

  • Valleywise Health Medical Center Hospital, Phoenix, AZ, CCN 030022

Merit-based Incentive Payment System (MIPS)

Final score
90.94 of 100Reported as apm
Quality
69.71
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
D012389AZMDGeneral Practice Dentistry
29779WVMDLicensed Practical Nurse
62798MNMDOral & Maxillofacial Surgery (D.M.D.)
D13292MNMDOral & Maxillofacial Surgery (D.M.D.)

Practice roles

OrganizationSpecialtyStatusNew patients
Charleston Area Medical Center Inc CurrentSince Jul 1, 2020 Accepting new patients
District Medical Group, Inc CurrentSince Feb 1, 2025 Accepting new patients
Maricopa County Special Health Care District CurrentSince Feb 13, 2025 Accepting new patients
District Medical Group, Inc Current Accepting new patients
District Medical Group, Inc CurrentSince Feb 1, 2025 Accepting new patients
Charleston Area Medical Center, Inc. CurrentSince Jul 1, 2020 Accepting new patients
Maricopa County Special Health Care District CurrentSince Feb 13, 2025 Accepting new patients
Maricopa County Special Health Care District Current Accepting new patients
District Medical Group, Inc Past Accepting new patients

Locations

950 E Van Buren St
Avondale, AZ 85323
Phone (623) 344-6800

811 S Hamilton St
Chandler, AZ 85225
Phone (480) 344-6100

8088 W Whitney Dr
Peoria, AZ 85345
Phone (602) 655-2000

33 W Tamarisk St
Phoenix, AZ 85041
Phone (602) 344-6400

2929 E Thomas Rd
Phoenix, AZ 85016
Phone (602) 470-5043

3141 N 3rd Ave
Ste 100
Phoenix, AZ 85013
Phone (602) 914-1520

2601 E Roosevelt St
Phoenix, AZ 85008
Phone (602) 220-0298

3141 N 3rd Ave
Phoenix, AZ 85013
Phone (602) 914-1520

2525 E Roosevelt St
Phoenix, AZ 85008
Phone (602) 344-1015

1101 N Central Ave
Ste 106
Phoenix, AZ 85004
Phone (602) 344-8717

501 Morris St
Charleston, WV 25301
Phone (304) 348-6293

415 Morris St
Ste 309
Charleston, WV 25301
Phone (304) 348-3290

Interoperability endpoints

  • Direct secure messaging: swaris280554@direct.valleywisehealth.org

Organizations & group practices 9

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.

Hospital & facility affiliations 12

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1369785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787184000000",
    "number": "1952748196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2929 E THOMAS RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850168034",
            "telephone_number": "602-470-5000",
            "fax_number": "602-470-5064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 E ROOSEVELT ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850084948",
            "telephone_number": "602-344-1015"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "415 Morris St Ste 309",
            "address_purpose": "LOCATION",
            "city": "Charleston",
            "state": "WV",
            "postal_code": "253011853",
            "country_code": "US",
            "telephone_number": "304-388-3290",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "200 1st St SW",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "MN",
            "postal_code": "559050001",
            "country_code": "US",
            "telephone_number": "507-284-2511",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WARIS",
        "first_name": "SAMIR",
        "credential": "MD, DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-05-29",
        "last_updated": "2026-08-20",
        "certification_date": "2026-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "D012389",
            "primary": false
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "AZ",
            "license": "74684",
            "primary": true
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "MN",
            "license": "62798",
            "primary": false
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "MN",
            "license": "D13292",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.