MEDICARE: IBRAM SAMUEL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	DB-2026-0184	NM

General Provider Information

NPI Number	:	1831022508
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	IBRAM SAMUEL

Provider Business Mailing Address
First Line	:	4550 EUBANK BLVD NE STE 101
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87111-2565
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4550 EUBANK BLVD NE STE 101
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87111-2565
Country	:	US
Telephone Number	:	505-292-8588
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/04/2026
Last Update Date	:	06/04/2026

Similar Medicare Providers

1215525902 — AUGUST VOJDANI PA-C
Practice Location Address:

4588 PARADISE BLVD NW , MEDICARE ADVANTAGE CLINIC
ALBUQUERQUE, NM
87114-4105

Practice Phone: 505-998-1840
Practice Fax: 505-998-1841

1952497588 — DR. LEONARD JAMES BACA D.D.S.
Practice Location Address:

4550 EUBANK NE , SUITE 101
ALBUQUERQUE, NM
87111-2565

Practice Phone: 505-292-8588
Practice Fax: 505-292-3100

1124287206 — REDEMPTION
Practice Location Address:

4550 EUBANK N.E. , SUITE 207
ALBUQUERQUE, NM
87111-2565

Practice Phone: 505-291-9500
Practice Fax:

1396990677 — DR. DANA LYNN GILES M.D.
Practice Location Address:

4550 EUBANK BLVD NE STE 103
ALBUQUERQUE, NM
87111-2565

Practice Phone: 505-384-7030
Practice Fax: 505-294-3397

1225279250 — DR. CARLA M GARCIA D.O.M.
Practice Location Address:

4550 EUBANK BLVD NE STE 105
ALBUQUERQUE, NM
87111-2565

Practice Phone: 505-271-6608
Practice Fax:

1104124080 — W GREGORY ROSE DDS PA
Practice Location Address:

4550 EUBANK BLVD NE , SUITE 201
ALBUQUERQUE, NM
87111-2565

Practice Phone: 505-296-5544
Practice Fax: 505-296-6918

Directions to “ IBRAM SAMUEL ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.