Provider Demographics
NPI:1346123809
Name:OTERO, SAMANTHA (DMD)
Entity type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:
Last Name:OTERO
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10400 SW 98TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-2776
Mailing Address - Country:US
Mailing Address - Phone:305-972-6134
Mailing Address - Fax:
Practice Address - Street 1:101 WESTWARD DR STE A
Practice Address - Street 2:
Practice Address - City:MIAMI SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33166-5211
Practice Address - Country:US
Practice Address - Phone:305-885-1357
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-30
Last Update Date:2025-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN30453122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist