Provider Demographics
NPI:1073325361
Name:SAMAROO, SAMUEL (DDS)
Entity type:Individual
Prefix:DR
First Name:SAMUEL
Middle Name:
Last Name:SAMAROO
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1125 N MCCARRAN BLVD STE 107
Mailing Address - Street 2:
Mailing Address - City:SPARKS
Mailing Address - State:NV
Mailing Address - Zip Code:89431-4607
Mailing Address - Country:US
Mailing Address - Phone:775-359-9300
Mailing Address - Fax:
Practice Address - Street 1:1125 N MCCARRAN BLVD STE 107
Practice Address - Street 2:
Practice Address - City:SPARKS
Practice Address - State:NV
Practice Address - Zip Code:89431-4607
Practice Address - Country:US
Practice Address - Phone:775-359-9300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-23
Last Update Date:2025-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV81421223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice