Samuel Nicholas Durham, DDS, MS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

30.023729 Issued in OH

Practice address

655 7TH St
Robins AFB, GA 31098

Phone

(478) 327-8487

NPI assigned

Apr 20, 2012

Last updated

Sep 1, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1334880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693526400000",
    "number": "1982961512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "655 7TH ST",
            "city": "ROBINS AFB",
            "state": "GA",
            "postal_code": "310982227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "655 7TH ST",
            "city": "ROBINS AFB",
            "state": "GA",
            "postal_code": "31098",
            "telephone_number": "478-327-8487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DURHAM",
        "first_name": "SAMUEL",
        "middle_name": "NICHOLAS",
        "name_prefix": "Dr.",
        "credential": "DDS, MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-20",
        "last_updated": "2023-09-01",
        "certification_date": "2023-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "30.023729",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark A Dammen, FNP
• Robert Michael Desantis, IDMT
• James Darrell Dixon, D.M.D.
• Biljana Djordjevic Drake, LCSW
• Ashley Nicole Drown, DDS
• Kathryn McInvale Evans, PA-C
• Robert Ferguson
• Amanda Marie Fletcher, FNP-C
• Michael Rutledge Frayser, D.O.
• Jeffrey Freeland

• General Practice Dentistry in Robins AFB, GA
• Providers in Robins AFB, GA by specialty
• General Practice Dentistry in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2023; 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.