Active NPI
Lawkpezi Abide Bagnabana
- Public Health Dentistry
- Roanoke Rapids, NC
National Provider Identifier
1093334971
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Public Health Dentistry
- License
- 13655
- Practice address
- 2064 NC-125
Roanoke Rapids, NC 27870 - Phone
- (252) 536-5880
- NPI assigned
- Apr 10, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DS043396 | PA | |
| Public Health Dentistry | 1223D0001X | 13655 | NC | Primary |
Addresses
Primary practice location
2064 NC-125
Roanoke Rapids, NC 27870
Mailing address
1509 Cedar Cliff Dr
Camp Hill, PA 17011-7720
Phone (717) 999-5605
Other practice location 1
9409 NC-305
Jackson, NC 27845
Phone (252) 536-5920
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Dentist
- Education
- Other, 2021
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
9425 Delegates Row
Indianapolis, IN 46240-3805
PO Box
Suite 640
Roanoke Rapids, NC 27870
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DS043396 | PA | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Elite Dental LLC | Past | Accepting new patients |
Interoperability endpoints
- lbagnabana707215@direct.ochin.org
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 and National Provider Directory roles.
-
- Federally Qualified Health Center (FQHC)
- Jackson, NC
- NPI 1689626178
-
- General Practice Dentistry
- Lancaster, PA
- NPI 1467952903
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1586476800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1781049600000",
"number": "1093334971",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1509 CEDAR CLIFF DR",
"city": "CAMP HILL",
"state": "PA",
"postal_code": "170117720",
"telephone_number": "717-999-5605"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2064 NC-125",
"city": "ROANOKE RAPIDS",
"state": "NC",
"postal_code": "27870",
"telephone_number": "252-536-5880"
}
],
"practiceLocations": [
{
"address_1": "9409 NC-305",
"address_purpose": "LOCATION",
"city": "Jackson",
"state": "NC",
"postal_code": "27845",
"country_code": "US",
"telephone_number": "252-536-5920",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BAGNABANA",
"first_name": "LAWKPEZI",
"middle_name": "ABIDE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-04-10",
"last_updated": "2026-06-10",
"certification_date": "2026-06-10",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "PA",
"license": "DS043396",
"primary": false
},
{
"code": "1223D0001X",
"taxonomy_group": "",
"desc": "Dentist, Dental Public Health",
"state": "NC",
"license": "13655",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Roanoke Rapids, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2026; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.