Individual provider Active NPI

Josh Samuel, DMD

  • Pediatric Dentistry
  • St Petersburg, FL
National Provider Identifier
1992322044
Registry record updated May 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
DN25546 Issued in FL
Practice address
11201 Corporate Cir N Ste 160
St Petersburg, FL 33716-3701
Phone
(727) 577-4911
NPI assigned
Jul 5, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 9, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X DN25546 FL Primary

Addresses

Primary practice location

11201 Corporate Cir N Ste 160
St Petersburg, FL 33716-3701

Mailing address

1115 E Twiggs St Unit 1416
Tampa, FL 33602-3183
Phone (954) 875-5447

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN25546FLMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Josh Samuel DMD PA Pediatric Dentistry CurrentSince May 11, 2025 Accepting new patients

Locations

11201 Corporate Cir N
Ste 160
St Petersburg, FL 33716
Phone (727) 557-4911

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1593907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746748800000",
    "number": "1992322044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1115 E TWIGGS ST UNIT 1416",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336023183",
            "telephone_number": "954-875-5447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11201 CORPORATE CIR N STE 160",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337163701",
            "telephone_number": "727-577-4911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMUEL",
        "first_name": "JOSH",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-07-05",
        "last_updated": "2025-05-09",
        "certification_date": "2025-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "FL",
            "license": "DN25546",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2025; 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.