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General NPI Number Information
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NPI Number | 1851383848
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Entity Type | Individual
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Provider Name | SAMANTHA CALLAHAN D.D.S.
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Gender | Female
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Dates
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Enumeration Date | 08/17/2005
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Last Update Date | 04/24/2015
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Provider Practice Location Address
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Address Line | 475 E BELL RD SUITE 150
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City | PHOENIX
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State | AZ
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Zip | 85022-2348
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Country | US
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Telephone | 623-866-5581
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Fax |
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Provider Business Mailing Address
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Address Line | 33600 N 27TH DR UNIT #1012
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City | PHOENIX
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State | AZ
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Zip | 85085-7771
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Country | US
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Telephone | 770-855-3045
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223D0001X
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Taxonomy Name | Public Health Dentistry
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License Number | DN11078
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 06016
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 9185
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License Number State | AZ
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