Active NPI
Marquez Jamar Sams, DMD
- Periodontics
- Wichita, KS
National Provider Identifier
1972629921
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- 60623
- Practice address
- 555 N Carriage Pkwy
Wichita, KS 67208-4506 - Phone
- (316) 683-2525
- Fax
- (316) 683-9385
- NPI assigned
- Mar 21, 2007
- Last updated
- Nov 23, 2010
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Periodontics | 1223P0300X | 60623 | KS | Primary |
Addresses
Primary practice location
555 N Carriage Pkwy
Wichita, KS 67208-4506
Mailing address
555 N Carriage Pkwy
Wichita, KS 67208-4506
Phone (316) 683-2525
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Jan 25, 2016 through Jan 25, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 60623 | KS | MD | Periodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174435200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1290470400000",
"number": "1972629921",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "555 N CARRIAGE PKWY",
"city": "WICHITA",
"state": "KS",
"postal_code": "672084506",
"telephone_number": "316-683-2525",
"fax_number": "316-683-9385"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "555 N CARRIAGE PKWY",
"city": "WICHITA",
"state": "KS",
"postal_code": "672084506",
"telephone_number": "316-683-2525",
"fax_number": "316-683-9385"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SAMS",
"first_name": "MARQUEZ",
"middle_name": "JAMAR",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-03-21",
"last_updated": "2010-11-23",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "KS",
"license": "60623",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wichita, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.