Samuel John Douglas, DDS
NPI 1124867924ActiveIndividual· Dentist· Lees Summit, MO
Opted out of Medicare from June 2024 to June 2028. Dentist (DDS) in Lees Summit, Missouri, licensed in MO, with an NPI issued in May 2024. Align Technology, Inc. reported $142.09 in payments in 2025, mostly food and beverage.
Overview
| NPI | 1124867924 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | DDS |
| Sole proprietor | No |
| NPI issued | May 21, 2024 |
| Last updated in NPPES | Jun 11, 2024 |
| Certified by provider | Jun 11, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dentist Primary | 122300000X | 2024021490 | MO |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|---|
| Opt-out | Opted out Jun 12, 2024 – Jun 12, 2028 |
| Can order and refer | No |
During an opt-out period the provider sees Medicare patients only under private contracts, and Medicare does not pay claims for their services.
Industry payments (Open Payments)
- 2025$142.09 · 1 payment from 1 company
Top paying companies in 2025
| Company | Amount | Payments |
|---|---|---|
| Align Technology, Inc. | $142.09 | 1 |
What the 2025 payments were for
- Food and Beverage$142.09 · 1 payment
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
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