MEDICARE: SAMUEL STRONG CALLISTER DMD

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	D-00208	KY

General Provider Information

NPI Number	:	1851221048
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAMUEL STRONG CALLISTER DMD

Provider Business Mailing Address
First Line	:	633 HUGGING BEAR DR
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40509-4392
Country	:	US
Telephone Number	:	801-380-3154
Fax Number	:

Provider Business Practice Location Address
First Line	:	633 HUGGING BEAR DR
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40509-4392
Country	:	US
Telephone Number	:	801-380-3154
Fax Number	:

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

Provider Enumeration Date	:	05/20/2026
Last Update Date	:	05/20/2026

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Directions to “ SAMUEL STRONG CALLISTER DMD” Practice Location

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