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KENNETH SAMUELSON DDS
NPI 1275674574
Dentist in Nellis Afb, NV

Active since February 09, 2007PECOS Enrolled
4700 LAS VEGAS BLVD N, NELLIS AFB, NV 89191(702) 653-2600 Get Directions Write a Review

NPPES record last updated: November 19, 2018. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Kenneth Samuelson Dds NPPES

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

KENNETH SAMUELSON DDS (NPI 1275674574) is an individual dentist in Nellis Afb, Nevada, licensed in California (32611) and active in the NPI registry since February 2007. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1275674574
Entity TypeIndividualMale
Primary Taxonomy122300000X
Provider Legal NameKENNETH SAMUELSONCredential: DDS
Location Address4700 LAS VEGAS BLVD NNellis Afb, NV 89191-6600
Mailing Address4700 Las Vegas Blvd NNellis Afb, NV 89191-6600 · (702) 653-2600
Phone(702) 653-2600
Sole ProprietorNo
Enumeration DateFebruary 9, 2007
Last NPPES UpdateNovember 19, 2018
✔ NPI 1275674574 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers
Taxonomy Code122300000X
License✔ Licensed in CA · 32611
Definition
A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.
4700 LAS VEGAS BLVD N, Nellis Afb, NV 89191
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kenneth Samuelson Dds is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 89191 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$88.51 typical visit price
range $57.07 – $173.24
Typical copayment $22.12 (range $14.26 – $43.31)
Most-billed visit code 99203
Established Patient
$71.14 typical visit price
range $18.27 – $140.96
Typical copayment $17.78 (range $4.56 – $35.24)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

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

DR. DEBRA A KOENIGSBERGER MD
Integrative Medicine
4700 LAS VEGAS BLVD N
NELLIS AFB, NV 89191
Clark County (702) 653-2267
KATRINA BAUMANN DPT
Physical Therapist (Orthopedic)
4700 LAS VEGAS BLVD N
NELLIS AFB, NV 89191
Clark County (702) 653-2273
JAMEAKA L. HAMILTON M.D.
Obstetrics & Gynecology
4700 LAS VEGAS BLVD N
NELLIS AFB, NV 89191
Clark County (702) 653-2300
SOUKAINA NOOR MD
Psychiatry & Neurology (Neurology)
4700 LAS VEGAS BLVD N
NELLIS AFB, NV 89191
Clark County (702) 653-2273
EDWARD KEMPTON MD
Emergency Medicine
4700 LAS VEGAS BLVD N
NELLIS AFB, NV 89191
Clark County (702) 653-2273
DR. AARON JOSEPH WOLBRUECK DO
Internal Medicine
4700 LAS VEGAS BLVD N
NELLIS AFB, NV 89191
Clark County (702) 653-2273
MARIA M ARAQUE PHARMD
Pharmacist
4700 LAS VEGAS BLVD N
NELLIS AFB, NV 89191
Clark County (702) 653-3202
DR. SHUBHANG N MAZUMDAR M.D.
Internal Medicine
4700 LAS VEGAS BLVD N
NELLIS AFB, NV 89191
Clark County (702) 653-3800

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 Kenneth Samuelson's NPI number?

The NPI number for Kenneth Samuelson is 1275674574. It was assigned to this individual provider in the NPPES registry on February 9, 2007.

Where is Kenneth Samuelson located?

Kenneth Samuelson practices at 4700 Las Vegas Blvd N, Nellis Afb, NV 89191. The listed phone number is (702) 653-2600.

What is Kenneth Samuelson's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Is Kenneth Samuelson enrolled in Medicare?

Yes. Kenneth Samuelson is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Kenneth Samuelson was last updated on November 19, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.