1649250663 NPI number — DR. DENNIS GREGORY SAMPSON DDS

Table of content: DR. DENNIS GREGORY SAMPSON DDS (NPI 1649250663)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1649250663 NPI number — DR. DENNIS GREGORY SAMPSON DDS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SAMPSON
Provider First Name:
DENNIS
Provider Middle Name:
GREGORY
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DDS
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1649250663
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/10/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
NAVY MEDICINE READINESS AND TRAINING UNIT KINGS BAY
Provider Second Line Business Mailing Address:
881 USS JAMES MADISON RD, BLDG 1028
Provider Business Mailing Address City Name:
KINGS BAY
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
31547
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
912-573-4230
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
315 MCHUGH BLVD
Provider Second Line Business Practice Location Address:
2D DENTAL BATTALION/ NAVAL DENTAL CENTER
Provider Business Practice Location Address City Name:
CAMP LEJEUNE
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28547-2511
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
910-451-2208
Provider Business Practice Location Address Fax Number:
910-451-8036
Provider Enumeration Date:
01/17/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1223G0001X , with the licence number:  DN123384 , registered in the state of GA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 1223G0001X , with the licence number: 0401410541 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 1223G0001X , with the licence number: DTC81 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)





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