Individual provider Active NPI

Samir Alrajab, DMD

  • Dentist
  • Austin, TX
National Provider Identifier
1972059103
Registry record updated Aug 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
32219 Issued in TX
Practice address
500 Canyon Ridge Dr
Austin, TX 78753-1632
Phone
(512) 837-2900
NPI assigned
Aug 28, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 32219 TX Primary

Addresses

Primary practice location

500 Canyon Ridge Dr
Austin, TX 78753-1632

Mailing address

11721 Domain Blvd
Unit #3344
Austin, TX 78758
Phone (832) 860-4052

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

LicenseStateTypeSpecialty
32219TXMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1472342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472342400000",
    "number": "1972059103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11721 DOMAIN BLVD",
            "address_2": "UNIT #3344",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "78758",
            "telephone_number": "832-860-4052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 CANYON RIDGE DR",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787531632",
            "telephone_number": "512-837-2900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALRAJAB",
        "first_name": "SAMIR",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-08-28",
        "last_updated": "2016-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "32219",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2016; 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.