MEDICARE: SAM E ENGLISH

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	1223G0001X	General Practice Dentistry	0401004082	VA

General Provider Information

NPI Number	:	1568585727
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SAM E ENGLISH

Provider Business Mailing Address
First Line	:	PO BOX 945
Second Line	:
City	:	WEST POINT
State	:	VA
Zip	:	23181-0945
Country	:	US
Telephone Number	:	804-843-3233
Fax Number	:	804-843-4033

Provider Business Practice Location Address
First Line	:	5303 PLAZA DR
Second Line	:	SUITE 103
City	:	HOPEWELL
State	:	VA
Zip	:	23860-7331
Country	:	US
Telephone Number	:	804-458-5047
Fax Number	:	804-458-0113

Authorized Official
Title or Position	:	DENTIST
Name	:	SAM E ENGLISH II
Credential	:	D.D.S.
Telephone Number	:	804-843-3233

Provider Enumeration Date	:	04/10/2007
Last Update Date	:	08/22/2020

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