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DR. SAMUEL THOMAS WELLS DMD
NPI 1154002194
Dentist - General Practice in Portland, OR

Active since July 31, 2023Opted out of Medicare · through Jul 1, 2028
833 SW 11TH AVE STE 405, PORTLAND, OR 97205(503) 228-6870(503) 222-7189 Get Directions Write a Review

NPPES record last updated: July 31, 2023. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Dr. Samuel Thomas Wells Dmd NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. SAMUEL THOMAS WELLS DMD (NPI 1154002194) is an individual general practice provider in Portland, Oregon, licensed in Oregon (11809) and active in the NPI registry since July 2023. He has opted out of Medicare through July 1, 2028.

NPPES Registry Identity

NPI1154002194
Entity TypeIndividualMale
Primary Taxonomy1223G0001X
Provider Legal NameDR. SAMUEL THOMAS WELLSCredential: DMD
Location Address833 SW 11TH AVE STE 405Portland, OR 97205-2118
Mailing Address833 Sw 11th Ave Ste 405Portland, OR 97205-2118 · (503) 228-6870
Phone(503) 228-6870
Fax(503) 222-7189
Sole ProprietorNo
Enumeration DateJuly 31, 2023
NPPES CertifiedJuly 31, 2023
✔ NPI 1154002194 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
License✔ Licensed in OR · 11809
Definition
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
833 SW 11TH AVE STE 405, Portland, OR 97205
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Dr. Samuel Thomas Wells Dmd has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from July 1, 2026 through July 1, 2028.

Opt-Out Effective DateJuly 1, 2026
Opt-Out In Effect ThroughJuly 1, 2028Opt-out affidavits renew automatically every two years unless cancelled

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SAMUEL T WELLS, DMD, LLC
Dentist
833 SW 11TH AVE STE 405
PORTLAND, OR 97205
Multnomah County (503) 228-6870

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Samuel Wells's NPI number?

The NPI number for Samuel Wells is 1154002194. It was assigned to this individual provider in the NPPES registry on July 31, 2023.

Where is Samuel Wells located?

Samuel Wells practices at 833 SW 11th Ave Ste 405, Portland, OR 97205. The listed phone number is (503) 228-6870.

What is Samuel Wells's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Is Samuel Wells enrolled in Medicare?

No. Samuel Wells has opted out of Medicare through July 1, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

When was this NPI record last updated?

The NPPES record for Samuel Wells was last updated on July 31, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.