Individual provider Active NPI

Elochukwu Adibe, D.M.D.

  • Prosthodontics
  • Monroe Township, NJ
National Provider Identifier
1083715734
Registry record updated Dec 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ProsthodonticsTaxonomy code 1223P0700X
License
22DI02314900 Issued in NJ
Practice address
2 Research Way Ste 201
Monroe Township, NJ 08831-6820
Phone
(609) 395-9100
Fax
(609) 395-9101
NPI assigned
Sep 26, 2006
Last updated
Dec 4, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 051169 NY
Prosthodontics 1223P0700X DS036867 PA
Prosthodontics 1223P0700X 22DI02314900 NJ Primary

Addresses

Primary practice location

2 Research Way Ste 201
Monroe Township, NJ 08831-6820

Mailing address

124 Summer Ridge Dr
Lansdale, PA 19446-6710
Phone (267) 263-4899

Other practice location 1

327 Township Line Rd
Elkins Park, PA 19027-2222
Phone (215) 663-1223

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
051169NYMDGeneral Practice Dentistry
22DI02314900NJMDProsthodontist
DS036867PAMDProsthodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Teeth Whitening Center Past Accepting new patients
Advanced Family Dental Care PC Past Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575417600000",
    "number": "1083715734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "124 SUMMER RIDGE DR",
            "city": "LANSDALE",
            "state": "PA",
            "postal_code": "194466710",
            "telephone_number": "267-263-4899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 RESEARCH WAY STE 201",
            "city": "MONROE TOWNSHIP",
            "state": "NJ",
            "postal_code": "088316820",
            "telephone_number": "609-395-9100",
            "fax_number": "609-395-9101"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "327 Township Line Rd",
            "address_purpose": "LOCATION",
            "city": "Elkins Park",
            "state": "PA",
            "postal_code": "190272222",
            "country_code": "US",
            "telephone_number": "215-663-1223",
            "fax_number": "215-663-1299",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ADIBE",
        "first_name": "ELOCHUKWU",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-26",
        "last_updated": "2019-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "051169",
            "primary": false
        },
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "PA",
            "license": "DS036867",
            "primary": false
        },
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "NJ",
            "license": "22DI02314900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monroe Township, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2019; 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.