NPIMap

Organization Active NPI

Wilford Samson Family Dentistry

  • Dentist
  • Old Saybrook, CT
National Provider Identifier
1972871135
Registry record updated Dec 2, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
009243 Issued in CT
Legal business name
WILFORD SAMSON FAMILY DENTISTRY
Practice address
25 Stage Rd
Old Saybrook, CT 06475-4232
Phone
(860) 388-3845
Fax
(860) 388-9023
NPI assigned
Dec 2, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2011

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

Authorized official

Name
Dr. Wilford Samson, D.D.S.
Title
Owner
Phone
(860) 388-3845

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 009243 CT Primary

Addresses

Primary practice location

25 Stage Rd
Old Saybrook, CT 06475-4232

Mailing address

25 Stage Rd
Old Saybrook, CT 06475-4232
Phone (860) 388-3845

National Provider Directory

National Provider Directory
Tax ID family
Samson Dental3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1322784000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1322784000000",
    "number": "1972871135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 STAGE RD",
            "city": "OLD SAYBROOK",
            "state": "CT",
            "postal_code": "064754232",
            "telephone_number": "860-388-3845",
            "fax_number": "860-388-9023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 STAGE RD",
            "city": "OLD SAYBROOK",
            "state": "CT",
            "postal_code": "064754232",
            "telephone_number": "860-388-3845",
            "fax_number": "860-388-9023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILFORD SAMSON FAMILY DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-02",
        "last_updated": "2011-12-02",
        "status": "A",
        "authorized_official_last_name": "SAMSON",
        "authorized_official_first_name": "WILFORD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "860-388-3845",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "CT",
            "license": "009243",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Old Saybrook, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 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.

Verify at the official NPI Registry.