Provider Demographics
NPI:1992322044
Name:SAMUEL, JOSH (DMD)
Entity type:Individual
Prefix:DR
First Name:JOSH
Middle Name:
Last Name:SAMUEL
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1115 E TWIGGS ST UNIT 1416
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33602-3183
Mailing Address - Country:US
Mailing Address - Phone:954-875-5447
Mailing Address - Fax:
Practice Address - Street 1:11201 CORPORATE CIR N STE 160
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33716-3701
Practice Address - Country:US
Practice Address - Phone:727-577-4911
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-05
Last Update Date:2025-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN255461223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry