Active NPI
Samantha Kerina Edwards, RDH
- Dental Hygienist
- West Park, FL
National Provider Identifier
1962793554
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- DH18493
- Practice address
- 2115 SW 50TH Ave
West Park, FL 33023-3235 - Phone
- (954) 478-2743
- NPI assigned
- Apr 29, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | DH18493 | FL | Primary |
Addresses
Primary practice location
2115 SW 50TH Ave
West Park, FL 33023-3235
Mailing address
2115 SW 50 TH Avenue
West Park, FL 33023
Phone (954) 478-2743
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DH18493 | FL | MD | Dental Hygienist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1304035200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1304035200000",
"number": "1962793554",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2115 SW 50 TH AVENUE",
"city": "WEST PARK",
"state": "FL",
"postal_code": "33023",
"telephone_number": "954-478-2743"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2115 SW 50TH AVE",
"city": "WEST PARK",
"state": "FL",
"postal_code": "330233235",
"telephone_number": "954-478-2743"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EDWARDS",
"first_name": "SAMANTHA",
"middle_name": "KERINA",
"name_prefix": "Mrs.",
"credential": "RDH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-04-29",
"last_updated": "2011-04-29",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "FL",
"license": "DH18493",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Park, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.