Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1679534895 Individual Practitioner Male Practitioner

Dr. Javier A Samudio , DDS

Dentist • Far Rockaway, NY

Professional Overview & Biography Verified Profile Summary

Dr. Javier Samudio, DDS is a registered healthcare professional specializing in Dentist in Far Rockaway, NY. Practice services are available at 1847 MOTT AVE FL 2 under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

1847 Mott Ave Fl 2

Far Rockaway, NY 116914201

Telephone 7183277000
Fax 7184712071
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist in Far Rockaway, NY

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 24.5 Yrs
Regional Practice Density
14 Specialists

Practicing in Far Rockaway, NY (6355 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Dentist Primary Specialty

NUCC Taxonomy Code: 122300000X

State License NY 044530

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.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
01400191 (NY)

Practice Associates & Co-Workers

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

1 Associated Practitioners
Dr. Shelly Kakar , DDS

Dentist - General Practice

NPI 1306177993

Doctor of Dental Surgery

Career & Practice History Timeline

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

6 Historical Events
NPI Profile Active October 02, 2012

NPI status registered as active in NPPES database

📍
Updated Practice Location October 02, 2012

Registered at 1847 MOTT AVE FL 2, FAR ROCKAWAY, NY 116914201 (Tel: 7183277000)

📍
Updated Business Mailing Address October 02, 2012

Registered at 3571 BUNKER AVE, WANTAGH, NY 117933438 (Tel: 5167653467)

👤
Provider Name / Credentials Updated October 02, 2012

Recorded as JAVIER SAMUDIO, DDS

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) October 02, 2012

Dentist (License #044530 in NY)

🟢
Initial NPI Registration & Enumeration March 29, 2006

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: 1679534895
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: March 29, 2006
Last Update: October 02, 2012
Sole Proprietor: Yes

Mailing Address

3571 Bunker Ave

Wantagh, NY 117933438

Phone: 5167653467

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.