DR. LEW B. SAMPLE (NPI# 1306969514) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306969514 |
| Entity Type | Individual |
| Full Name | DR. LEW B. SAMPLE |
| Credential | DMD, MS, PC |
| Practice Address |
2014 Danville Park Dr Sw Decatur AL 35603-1832 |
| Practice Telephone | 2563555255 |
| Mailing Telephone | 2563555255 |
| Enumeration Date | 2007-04-10 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223X0400X |
Dentist Specialization: Orthodontics and Dentofacial Orthopedics |
4668 | AL | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AL | LICENSE NUMBER | 4668 | 01 |
| AL | UNITED CONCORDIA | 982261 | 01 |
| AL | BLUE CROSS PROVIDER | 08038 | 01 |
| Street Address |
2014 DANVILLE PARK DR SW |
| City | DECATUR |
| State | AL |
| Zip Code | 35603-1832 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043858848 | Marcanna Michele Kimball | Technician | 1616 Saginaw Ln Sw, Decatur, AL 35603 | 2019-12-12 |
| 1316503808 | Julie Monteiro-pai | Nurse Practitioner | 2828 Us 31, Suite # 117, Decatur, AL 35603 | 2019-05-10 |
| 1700305372 | Jessica Skarda | Nurse Practitioner | 1577-1631 Kathy Ln Sw, Decatur, AL 35603 | 2017-09-14 |
| 1841532546 | Priceville Pharmacy LLC | Pharmacy | 2941 Point Mallard Pkwy, Suite A, Decatur, AL 35603 | 2013-03-20 |
| 1235392689 | David Gerardo Barraza | Nurse Practitioner | 2422 Donville Road, Suite E, Decatur, AL 35603 | 2008-07-07 |
| 1164629002 | Rachel E. Kennedy | Family Medicine | 2422 Danville Rd., Suite E, Decatur, AL 35603 | 2007-07-02 |
| 1558583708 | Active Physical Therapy, Inc. | Clinic/Center | 2424 Danville Rd. Sw, Ste M, Decatur, AL 35603 | 2007-05-03 |
| 1598829814 | Decatur Eye Institute | Optometrist | 2620 Centron Dirve Sw, Decatur, AL 35603 | 2006-12-21 |
| 1447326442 | Joseph R Dupper | Podiatrist | 2506 Danville Rd Sw Suite 204, Decatur, AL 35603 | 2006-11-28 |
| 1568531820 | Highlands Internal Medicine LLC | Internal Medicine | 2422 Danville Rd, Suite F, Decatur, AL 35603 | 2006-11-08 |
| Find all providers in zip 35603 | ||||
| Taxonomy Code | 1223X0400X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Orthodontics and Dentofacial Orthopedics |
| That area of dentistry concerned with the supervision, guidance and correction of the growing or mature dentofacial structures, including those conditions that require movement of teeth or correction of malrelationships and malformations of their related structures and the adjustment of relationships between and among teeth and facial bones by the application of forces and/or the stimulation and redirection of functional forces within the craniofacial complex. Major responsibilities of orthodontic practice include the diagnosis, prevention, interception and treatment of all forms of malocclusion of the teeth and associated alterations in their surrounding structures; the design, application and control of functional and corrective appliances; and the guidance of the dentition and its supporting structures to attain and maintain optimum occlusal relations in physiologic and esthetic harmony among facial and cranial structures. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033608971 | John Anderson Clinebell | Dentist | 3732 Lavista Rd, Decatur, GA 30033-1006 | 2018-05-07 |
| 1013418201 | Clark Clayton Browne Jr. | Dentist | 1815 Somerville Rd Se, Decatur, AL 35601-5015 | 2018-02-23 |
| 1053683854 | Jimiesh G Crane | Dentist | 5243 Snapfinger Woods Dr Ste 105, Decatur, GA 30035 | 2012-02-08 |
| 1831346188 | Rufus John Nelson | Dentist | 1710 S Hwy 51 Ste 20,pmb #176, 1000 W Business Hwy 380, Decatur, TX 76234 | 2008-08-19 |
| 1396808218 | John A. Clinebell, D.d.s., M.s., P.C. | Dentist | 3744 Lavista Rd, Suite A, Decatur, GA 30033-1006 | 2006-12-19 |
| 1023189206 | Mary Lynn Crews | Dentist | 1989 N Williamsburg Dr, Suite A, Decatur, GA 30033-3509 | 2006-11-10 |
| 1316028244 | Penny Lee Taylor | Dentist | 2514 Danville Rd Sw, Decatur, AL 35603-4213 | 2006-10-18 |
| 1013098045 | Catherine E. Cavanaugh | Dentist | 1353 E Mound Rd Ste 203, Decatur, IL 62526-3680 | 2006-10-18 |
| 1104912237 | Daniel C. Mallory | Dentist | 2250 South Fm 51, Suite 800, Decatur, TX 76234-3771 | 2006-10-05 |
| 1578541736 | Allise M. Calloway | Dentist | 4919 Flat Shoals Pkwy, Suite 210, Decatur, GA 30034-5258 | 2006-01-06 |
| Find all providers in DECATUR | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.