DR. SAMANTA ANDISCO D.M.D.
NPI 1326298753
Dentist - General Practice in Port Charlotte, FL

Q: What is Samanta Andisco's NPI number?

The NPI number for Samanta Andisco is 1326298753. It was assigned to this individual provider in the NPPES registry on September 23, 2008.

Q: What is Samanta Andisco's specialty?

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

Q: Is Samanta Andisco enrolled in Medicare?

No. Samanta Andisco has opted out of Medicare through November 10, 2026. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

Q: When was this NPI record last updated?

The NPPES record for Samanta Andisco was last updated on May 1, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.

Active since September 23, 2008Opted out of Medicare · through Nov 10, 2026

19240 QUESADA AVE, PORT CHARLOTTE, FL 33948(941) 743-7435(941) 743-7429 Get Directions Write a Review

NPPES record last updated: May 1, 2018. Verified against the NPPES registry weekly; last sync: August 02, 2026.

On this page

About Dr. Samanta Andisco D.m.d. NPPES

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

DR. SAMANTA ANDISCO D.M.D. (NPI 1326298753) is an individual general practice provider in Port Charlotte, Florida, licensed in Florida (DN17588) and active in the NPI registry since September 2008. She has opted out of Medicare through November 10, 2026.

NPPES Registry Identity

NPI1326298753

Entity TypeIndividualFemale

Primary Taxonomy1223G0001X

Provider Legal NameDR. SAMANTA ANDISCOCredential: D.M.D.

Location Address19240 QUESADA AVEPort Charlotte, FL 33948-3126

Mailing Address9500 Bonita Beach Rd Se Ste 301Bonita Springs, FL 34135-4698 · (239) 319-2440 · Fax (239) 319-2440

Phone(941) 743-7435

Fax(941) 743-7429

Sole ProprietorNo

Enumeration DateSeptember 23, 2008

Last NPPES UpdateMay 1, 2018

✔ NPI 1326298753 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers

Taxonomy Code1223G0001X

License✔ Licensed in FL · DN17588

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.

19240 QUESADA AVE, Port Charlotte, FL 33948

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

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Opted out of Medicare

Dr. Samanta Andisco D.m.d. 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 November 10, 2016 through November 10, 2026.

Opt-Out Effective DateNovember 10, 2016

Opt-Out In Effect ThroughNovember 10, 2026Opt-out affidavits renew automatically every two years unless cancelled

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 33948 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

$87.62 typical visit price

range $56.00 – $171.84

Typical copayment $21.90 (range $14.00 – $42.96)

Most-billed visit code 99203

Established Patient

$70.04 typical visit price

range $17.57 – $139.16

Typical copayment $17.51 (range $4.39 – $34.79)

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 6

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

PANTHER HOLLOW FAMILY DENTAL PA

Dentist (General Practice)