Individual provider Active NPI

Samuel Victor Rowe, D.M.D.

  • Dentist
  • Fort Pierce, FL
National Provider Identifier
1962673798
Registry record updated Mar 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN 10612 Issued in FL
Practice address
605 Citrus Ave
Fort Pierce, FL 34950-8353
Phone
(772) 461-2648
Fax
(772) 461-2691
NPI assigned
Mar 19, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN 10612 FL Primary

Addresses

Primary practice location

605 Citrus Ave
Fort Pierce, FL 34950-8353

Mailing address

605 Citrus Ave
Fort Pierce, FL 34950-8353
Phone (772) 461-2648

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20160328001619 FL Order and Referring Only - DentistPractitioner - Dentist 9335446889

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN 10612FLMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1205884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205884800000",
    "number": "1962673798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "605 CITRUS AVE",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349508353",
            "telephone_number": "772-461-2648",
            "fax_number": "772-461-2691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "605 CITRUS AVE",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349508353",
            "telephone_number": "772-461-2648",
            "fax_number": "772-461-2691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROWE",
        "first_name": "SAMUEL",
        "middle_name": "VICTOR",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-03-19",
        "last_updated": "2008-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN 10612",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Pierce, FL

Sources for this page

Verify at the official NPI Registry.