DR SAM DMD PC NPI 1366975419

NPI Information

  • NPI: 1366975419
  • Provider Name: DR SAM DMD PC
  • Classification: Clinic/Center - 261QD0000X
  • Specialization: Dental
  • Entity Type: Organization
  • Doing Business As: 162ND STREET DENTAL
  • Address: 1022 E 162ND ST
    SOUTH HOLLAND, IL
    ZIP 60473
  • Phone: (312) 493-6089

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NPI Details

DR SAM DMD PC is a dental clinic center in South Holland, IL. DR SAM DMD PC NPI is 1366975419. The provider is registered as an organization entity type.
The provider Is Doing Business As 162nd Street Dental.

The provider's business location address is:

1022 E 162ND ST
SOUTH HOLLAND, IL
ZIP 60473-560
Phone: (312) 493-6089

The provider's authorized official is Samuel Osobu .
The authorized official title is President and has the following contact phone number (312) 493-6089.

The enumeration date for this NPI number is 4/6/2017 and was last updated on 4/6/2017.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QD0000XClinic/CenterDental019030498ILLINOISYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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