Active NPI
Valentine C Emechete, DENTIST
- Dentist
- Mrianna, AR
National Provider Identifier
1093093247
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- AR3828
- Practice address
- 530 West Atkins Blvd
Mrianna, AR 72360 - Phone
- (870) 295-5225
- Fax
- (870) 295-6900
- NPI assigned
- Jul 21, 2011
- Last updated
- Jul 21, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | AR3828 | AR | Primary |
Addresses
Primary practice location
530 West Atkins Blvd
Mrianna, AR 72360
Mailing address
PO Box 669
Marianna, AR 72360-0669
Phone (870) 295-5225
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AR
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20180501000139 | AR | Order and Referring Only - Dentist | 2062776966 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AR3828 | AR | MD | Dentist |
| 3828 | AR | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1311206400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1311206400000",
"number": "1093093247",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 669",
"city": "MARIANNA",
"state": "AR",
"postal_code": "723600669",
"telephone_number": "870-295-5225",
"fax_number": "870-295-6900"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "530 WEST ATKINS BLVD",
"city": "MRIANNA",
"state": "AR",
"postal_code": "72360",
"telephone_number": "870-295-5225",
"fax_number": "870-295-6900"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EMECHETE",
"first_name": "VALENTINE",
"middle_name": "C",
"credential": "DENTIST",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-07-21",
"last_updated": "2011-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "AR",
"license": "AR3828",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.