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Deactivated NPI 1780882159 Deactivated / Inactive NPI Male Practitioner

Sammy Stefan Noumbissi

Dentist • Waldorf, MD

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Sammy Noumbissi has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date July 06, 2007
NPI Deactivation Date January 28, 2020
Total Practice Duration ~13 Years of Practice (2007 – 2020)

Professional Overview & Biography Verified Profile Summary

Sammy Noumbissi was a registered Dentist practicing in Waldorf, MD. Throughout an active medical career spanning 13 years, Sammy Noumbissi provided care at the practice location at 117 SAINT PATRICKS DR until profile deactivation on 2020-01-28.

Historical Medicare Part B clinical services included ct scan of face, x-ray of lower jaws, upper jaws and teeth, suture of (over 2.5 centimeter) mouth laceration. Public procedure reimbursement records and service volume details are provided below for historical transparency.

Practice Location & Contact Primary Location

Practice Address

117 Saint Patricks Dr

Waldorf, MD 206034574

Telephone 3018704553
Associated Practice Facility / Clinic
🏢 Neibauer Dental Care, Pc Facility NPI 1407123045

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist in Waldorf, MD

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 10.6 Yrs
Regional Practice Density
25 Specialists

Practicing in Waldorf, MD (1975 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
61.8% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2021)
HCPCS Code & Description Services Patients Submitted Charge Medicare Allowed
70486 CT scan of face
46 35 $807.10 $46.44
70355 X-ray of lower jaws, upper jaws and teeth
45 34 $620.00 $11.69
40831 Suture of (over 2.5 centimeter) mouth laceration
25 20 $826.12 $229.91
21208 Incision and repair of bony defect of cheek bone with repositioning of bony segment
25 18 $2200.00 $1351.56
99205 New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more
23 23 $457.90 $255.71
21210 Repair of nasal or cheek bone with bone graft
21 18 $4776.00 $2133.50
36513 Mechanical separation of platelet cells from blood
19 17 $240.92 $62.02
21085 Impression and custom preparation of oral surgical splint
13 12 $2000.00 $461.65

Medical Specialties & State Licenses

CMS Verified: 2020-03-06
Dentist Primary Specialty

NUCC Taxonomy Code: 122300000X

State License MD 12911

A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

12 Associated Practitioners
Dr. Rimple Singh , DDS

Dentist - General Practice

NPI 1033207956

Doctor of Dental Surgery

Dr. Amanda Taylor , DDS

Dentist - General Practice

NPI 1053748228

Doctor of Dental Surgery

NPI 1114281391

Doctor of Dental Surgery

Dr. Todd Bickling , DDS

Dentist - General Practice

NPI 1538257365

Doctor of Dental Surgery

Dr. Bhavinkumar Patel , DDS

Dentist - General Practice

NPI 1558569012

Doctor of Dental Surgery

NPI 1588790570

Doctor of Dental Surgery

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

11 Historical Events
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Updated Practice Location March 06, 2020

Registered at 117 SAINT PATRICKS DR, WALDORF, MD 206034574 (Tel: 3018704553)

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Updated Business Mailing Address March 06, 2020

Registered at 14921 SADDLE CREEK DR, BURTONSVILLE, MD 208662210 (Tel: 3018704553)

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Provider Name / Credentials Updated March 06, 2020

Recorded as SAMMY NOUMBISSI

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Medical Taxonomy / Specialty Registered (Primary Specialty) March 06, 2020

Dentist (License #12911 in MD)

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NPI Profile Deactivated January 28, 2020

Record deactivated on January 28, 2020

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

📍
Updated Practice Location July 08, 2007

Registered at 117 SAINT PATRICKS DR, WALDORF, MD 206034574 (Tel: 3018704553)

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Updated Business Mailing Address July 08, 2007

Registered at 14921 SADDLE CREEK DR, BURTONSVILLE, MD 208662210 (Tel: 3018704553)

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Provider Name / Credentials Updated July 08, 2007

Recorded as SAMMY NOUMBISSI

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Dentist (License #12911 in MD)

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Initial NPI Registration & Enumeration July 06, 2007

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1780882159
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: July 06, 2007
Last Update: March 06, 2020
Deactivation Date: January 28, 2020
Sole Proprietor: No

Mailing Address

14921 Saddle Creek Dr

Burtonsville, MD 208662210

Phone: 3018704553

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.