Question 1

What type of a medical provider is Samuel Tack?

Accepted Answer

Samuel Tack is a Dentist (Oral and Maxillofacial Surgery).

Question 2

Where does Samuel Tack practice medicine?

Accepted Answer

Samuel Tack has the following practice address:520 N 12TH ST, RICHMOND, VA 23298-5064

Question 3

Does this provider have a license number?

Accepted Answer

Samuel Tack has 2 license numbers, including: License Number 0401415733 issued in Virginia.

Question 4

Does Samuel Tack accept Medicare?

Accepted Answer

We do not know if this provider accepts the Medicare-approved amount.

Question 5

Does Samuel Tack have any board certifications?

Accepted Answer

The provider does not have any board certifications.

Question 6

Is Samuel Tack a member of any Medical Groups?

Accepted Answer

Samuel Tack is not affiliated with any medical groups.

Question 7

Does Samuel Tack participate in PECOS?

Accepted Answer

Yes, Samuel Tack participates in PECOS.

Question 8

What phone number can I call to contact Samuel Tack?

Accepted Answer

You can call the following number: (804)-628-7146

Question 9

Are there any exclusions against this provider?

Accepted Answer

We have not detected any Exclusions tied directly to Samuel Tack.

Question 10

Is Samuel Tack  affiliated with any hospitals?

Accepted Answer

The provider is not affiliated with any hospitals.

Question 11

When was this information last updated?

Accepted Answer

The CMS-based NPPES information was updated approximately 2 years ago (9/11/2023).

Taxonomy	State	Primary?
Dentist (Oral and Maxillofacial Surgery) - Taxonomy Code 1223S0112X	VA	Y
Student - Taxonomy Code 390200000X	VA	N

Participates in PECOS:	YES
PECOS Individual Enrollment ID:
PECOS Individual PAC ID:
Eligible to order/refer Part B Clinical Laboratory and Imaging	Yes
Eligible to order/refer Durable Medical Equipment (DME)	Yes
Eligible to order/refer Home Health Agency (HHA)	Yes
Eligible to order/refer Power Mobility Devices (PMD)	-

Samuel Tack

Overview