Gabriel Ehimen Ukegheson, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

D14841 Issued in MN

Practice address

1709 Ist Street S
Willmar, MN 56201

Phone

(320) 262-7176

NPI assigned

Sep 18, 2021

Sex

Male

Sole proprietor

No

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

State licenses

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.

• Smilesforever LLC

  • General Practice Dentistry
  • Alamogordo, NM
  • NPI 1396297560
  NPD (past)

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

{
    "created_epoch": "1631923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672099200000",
    "number": "1073283206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 N SYCAMORE AVE APT 214",
            "city": "ROSWELL",
            "state": "NM",
            "postal_code": "882018823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1709 IST STREET S",
            "city": "WILLMAR",
            "state": "MN",
            "postal_code": "56201",
            "telephone_number": "320-262-7176"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "780 Scenic Dr",
            "address_purpose": "LOCATION",
            "city": "Alamogordo",
            "state": "NM",
            "postal_code": "883104304",
            "country_code": "US",
            "telephone_number": "575-437-8994",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "UKEGHESON",
        "first_name": "GABRIEL",
        "middle_name": "EHIMEN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-09-18",
        "last_updated": "2022-12-27",
        "certification_date": "2022-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NM",
            "license": "DD5503",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MN",
            "license": "D14841",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leticia Trevino
• True Care Center LLC
• Barbara Maria Truskolawski, PHARM.D
• Brandon Tucker, DPM
• Jennifer Diane Twedt
• Chad Jason Ulferts, H.I.S
• Charles Dean Ulrich II, MD
• Holly Jean Ulrich, RPH
• Karen Ann Urban, LP
• Uscare Homecare, LLC

• Dentist in Willmar, MN
• Providers in Willmar, MN by specialty
• Dentist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2022; 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.