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Deactivated NPI 1073592697 Deactivated / Inactive NPI Male Practitioner

Dr. Samuel Davis , DDS

Dentist - General Practice • Ft. Sill, OK

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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, Dr. Samuel Davis has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date January 12, 2006
NPI Deactivation Date June 12, 2025
Total Practice Duration ~19 Years of Practice (2006 – 2025)

Professional Overview & Biography Verified Profile Summary

Dr. Samuel Davis, DDS was a registered Dentist - General Practice practicing in Ft. Sill, OK. Throughout an active medical career spanning 19 years, Dr. Davis provided care at the practice location at RANDOLPH ROAD until profile deactivation on 2025-06-12.

Practice Location & Contact Primary Location

Practice Address

Randolph Road
Cowan Dental Clinic Bldg 605

Ft. Sill, OK 73503

Telephone 5804425925

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Ft. Sill, OK

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 17.8 Yrs
Regional Practice Density
6 Specialists

Practicing in Ft. Sill, OK (1496 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 - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License OK 2789

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

Practice Associates & Co-Workers

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

19 Associated Practitioners
An Nguyen

Clinic/Center - Dental

NPI 1013716976
Dr. Meggin Passey , DDS

Dentist - General Practice

NPI 1093261695

Doctor of Dental Surgery

Jose Viteri , RDH

Dental Hygienist

NPI 1114994043

Registered Dental Hygienist

NPI 1275363061

Doctor of Dental Surgery

Meyon Walker

Dental Hygienist

NPI 1275486557
NPI 1285424861

Doctor of Dental Medicine

Career & Practice History Timeline

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

7 Historical Events
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NPI Profile Deactivated June 12, 2025

Record deactivated on June 12, 2025

NPI Profile Active November 21, 2008

NPI status registered as active in NPPES database

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Updated Practice Location November 21, 2008

Registered at RANDOLPH ROAD, COWAN DENTAL CLINIC BLDG 605, FT. SILL, OK 73503 (Tel: 5804425925)

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Updated Business Mailing Address November 21, 2008

Registered at 4075 SAINT CROIX DR, EDMOND, OK 730039123 (Tel: 4053488779)

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Provider Name / Credentials Updated November 21, 2008

Recorded as SAMUEL DAVIS, DDS

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Medical Taxonomy / Specialty Registered (Primary Specialty) November 21, 2008

Dentist (License #2789 in OK)

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Initial NPI Registration & Enumeration January 12, 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: 1073592697
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: January 12, 2006
Last Update: November 21, 2008
Deactivation Date: June 12, 2025

Mailing Address

4075 Saint Croix Dr

Edmond, OK 730039123

Phone: 4053488779

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.