Individual provider Active NPI

Lawkpezi Abide Bagnabana

  • Public Health Dentistry
  • Roanoke Rapids, NC
National Provider Identifier
1093334971
Registry record updated Jun 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health DentistryTaxonomy code 1223D0001X
License
13655 Issued in NC
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

Updated by the provider on Jun 10, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260521000858 NC Practitioner - Dentist 2062981822 Reassigns benefits to 1 organization

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

LicenseStateTypeSpecialty
DS043396PAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Elite Dental LLC PastSince Oct 1, 2021 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: 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.

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

Verify at the official NPI Registry.