Provider Demographics
NPI:1619403458
Name:MUELLER, SAMANTHA CLAIRE (DMD)
Entity Type:Individual
Prefix:DR
First Name:SAMANTHA
Middle Name:CLAIRE
Last Name:MUELLER
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:80 W HILLCREST BLVD STE 212
Mailing Address - Street 2:
Mailing Address - City:SCHAUMBURG
Mailing Address - State:IL
Mailing Address - Zip Code:60195-3111
Mailing Address - Country:US
Mailing Address - Phone:847-882-3360
Mailing Address - Fax:
Practice Address - Street 1:80 W HILLCREST BLVD STE 212
Practice Address - Street 2:
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60195-3111
Practice Address - Country:US
Practice Address - Phone:847-636-6767
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-11
Last Update Date:2022-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
IL019.0311031223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program