DR. SUMITA SUSAN SAM (DDS) – Oral and Maxillofacial Pathology Dentistry, NPI 1326561200
Oral and Maxillofacial Pathology Dentistry
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
4 ORAL AND MAXILLOFACIAL PATHOLOGY in FL
Provider Addresses for DR. SUMITA SUSAN SAM (DDS)
1600 SW Archer Rd
Gainesville, FL 326103006
Phone: (352) 273-6695
Fax: (352) 294-5310
Type: Location
28040, Middlebelt Road, Farmington Hills, Oakland County, Michigan, 48334, United States
FARMINGTON HILLS, MI 483344118
Phone:
Type: Mailing
Aspen Dental, 22010, Eureka Road, Taylor, Wayne County, Michigan, 48180, United States
TAYLOR, MI 48180
Phone: (313) 687-4748
Type: Location
9208 PARTHENON PL
SEFFNER, FL 335842659
Phone: (248) 605-1023
Type: Mailing
1395 CENTER DR RM D8-6
GAINESVILLE, FL 326103006
Phone: (352) 273-6703
Type: Location
PO BOX 100414
GAINESVILLE, FL 326100414
Phone: (352) 273-6695
Fax: (352) 294-5310
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2024-02-15
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20240215000110 | I | Oral And Maxillofacial Pathology | FL | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 32610)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Oral Surgery, Dentist | FL | |
| - | FL | |
| Oral Surgery | FL | |
| Oral And Maxillofacial Pathology, Oral Surgery | FL | |
| Oral Surgery | FL | |
| Oral Surgery, Oral And Maxillofacial Pathology | FL | |
| - | FL | |
| Oral Surgery | FL | |
| - | FL | |
| Oral Surgery | FL |
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