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SAMANTHA NIXON DMD
NPI 1902652720
Dentist in Shaw Afb, SC

Active since April 24, 2024
420 POLIFKA DR, SHAW AFB, SC 29152(803) 895-6356 Get Directions Write a Review

NPPES record last updated: February 22, 2026. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Sep 16, 2025, Jun 27, 2024, Apr 24, 2024 (3 updates tracked since 2024).

About Samantha Nixon Dmd NPPES

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

SAMANTHA NIXON DMD (NPI 1902652720) is an individual dentist in Shaw Afb, South Carolina, licensed in Tennessee (12480) and active in the NPI registry since April 2024. She maintains a secondary practice location in Eglin Afb.

NPPES Registry Identity

NPI1902652720
Entity TypeIndividualFemale
Primary Taxonomy122300000X
Provider Legal NameSAMANTHA NIXONCredential: DMD
Location Address420 POLIFKA DRShaw Afb, SC 29152-5100
Mailing Address420 Polifka DrShaw Afb, SC 29152-5100 · (803) 895-6356
Phone(803) 895-6356
Sole ProprietorNo
Enumeration DateApril 24, 2024
Last NPPES UpdateFebruary 22, 20263 updates tracked since enumeration
NPPES CertifiedFebruary 22, 2026
✔ NPI 1902652720 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers
Taxonomy Code122300000X
License✔ Licensed in TN · 12480
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.
420 POLIFKA DR, Shaw Afb, SC 29152
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Other Names 1

Former Name (1)Samantha Fitzgerald

Secondary Practice Location 1

Location 1307 Boatner Rd Ste 114Eglin AFB, FL 32542-1302 · Phone (850) 883-8324

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.

MRS. MALLORY SMITH NP
Nurse Practitioner (Primary Care)
420 POLIFKA DR
SHAW AFB, SC 29152
Sumter County (803) 895-2273
DESMOND JACOB MARROQUIN
Military Health Care Provider (Independent Duty Medical Technicians)
420 POLIFKA DR
SHAW AFB, SC 29152
Sumter County (803) 885-0249
ANA N CHAVIS PHARMD
Pharmacist (Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist)
420 POLIFKA DR
SHAW AFB, SC 29152
Sumter County (803) 895-6466
VALERIE LUISA VILLANUEVA PA-C
Physician Assistant (Medical)
420 POLIFKA DR
SHAW AFB, SC 29152
Sumter County (038) 956-5428
MS. THERESA JEAN ULICHNEY CNP
Nurse Practitioner (Women's Health)
420 POLIFKA DR
SHAW AFB, SC 29152
Sumter County (803) 895-6812
MS. QUOTAICHI NACHION RAMBUS MSW; LISW
Social Worker (Clinical)
420 POLIFKA DR
SHAW AFB, SC 29152
Sumter County (803) 895-6356
PATTI E BUSSER
Social Worker
420 POLIFKA DR
SHAW AFB, SC 29152
Sumter County (803) 895-6095
RODRIGO CARRASCO
Physician Assistant
420 POLIFKA DR
SHAW AFB, SC 29152
Sumter County (785) 240-5579

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 Samantha Nixon's NPI number?

The NPI number for Samantha Nixon is 1902652720. It was assigned to this individual provider in the NPPES registry on April 24, 2024. The provider is also known as Samantha Fitzgerald.

Where is Samantha Nixon located?

Samantha Nixon practices at 420 Polifka Dr, Shaw Afb, SC 29152. The listed phone number is (803) 895-6356.

What is Samantha Nixon's specialty?

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

When was this NPI record last updated?

The NPPES record for Samantha Nixon was last updated on February 22, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 months 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.