Kaycee Obi-Gwacham, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

11139 Issued in NC

Practice address

2200 Walters Division Rd
Monroe, NC 28110

Phone

(704) 289-1105

NPI assigned

Apr 18, 2017

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Modlin & Londry III DDS PLLC

  • General Practice Dentistry
  • Monroe, NC
  • NPI 1144709924
  NPD (past)
• Monique Hudson,DDS, PA

  • Dentist
  • Monroe, NC
  • NPI 1457703696

  Single Specialty

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1492473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535500800000",
    "number": "1013441831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19810 W CATAWBA AVE # A1",
            "city": "CORNELIUS",
            "state": "NC",
            "postal_code": "280314056",
            "telephone_number": "910-644-2884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 WALTERS DIVISION RD",
            "city": "MONROE",
            "state": "NC",
            "postal_code": "28110",
            "telephone_number": "704-289-1105"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "150 55th St",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112202508",
            "country_code": "US",
            "telephone_number": "910-644-2884",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OBI-GWACHAM",
        "first_name": "KAYCEE",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-04-18",
        "last_updated": "2018-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "11139",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrew S O'Connor, DO
• Mark P O'Dell, LCSW
• Alexandra Elizabeth Oakes, PA
• Oasis Horizons, LLC
• Oasis Risings, LLC
• Okoronkwo Uchenna Ogan, MD
• Wycliffe Okumu, MD
• Benedict O Okwara, M.D.
• Oluwabamise Olabode
• Evelyn A Oladapo

• General Practice Dentistry in Monroe, NC
• Providers in Monroe, NC by specialty
• General Practice Dentistry in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.