Active NPI
Daniel Nnadiugwu Nnadiugwu, D.D.S
- Dentist
- Mansfield, TX
National Provider Identifier
1114273430
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 28871
- Practice address
- 1521 E Debbie LN
Mansfield, TX 76063-3341 - Phone
- (817) 225-6702
- NPI assigned
- Jul 25, 2012
- Last updated
- Jan 27, 2016
- 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 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 60885 | KS | |
| Dentist | 122300000X | DS039601 | PA | |
| Dentist | 122300000X | 28871 | TX | Primary |
| Dentist | 122300000X | DDS-09265 | IA |
Addresses
Primary practice location
1521 E Debbie LN
Mansfield, TX 76063-3341
Mailing address
1521 E Debbie LN
Mansfield, TX 76063-3341
Phone (817) 225-6702
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3459224-01 | Medicaid | TX | |
| 3459224-02 | Medicaid | TX | |
| 3459224-04 | Medicaid | TX | |
| 3459224-03 | Medicaid | TX |
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
| License | State | Type | Specialty |
|---|---|---|---|
| DDS-09265 | IA | MD | Dentist |
| 60885 | KS | MD | Dentist |
| DS039601 | PA | MD | Dentist |
| 28871 | TX | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1343174400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1453852800000",
"number": "1114273430",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1521 E DEBBIE LN",
"city": "MANSFIELD",
"state": "TX",
"postal_code": "760633341",
"telephone_number": "817-225-6702"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1521 E DEBBIE LN",
"city": "MANSFIELD",
"state": "TX",
"postal_code": "760633341",
"telephone_number": "817-225-6702"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NNADIUGWU",
"first_name": "DANIEL",
"middle_name": "NNADIUGWU",
"name_prefix": "Dr.",
"credential": "D.D.S",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-07-25",
"last_updated": "2016-01-27",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "KS",
"license": "60885",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "PA",
"license": "DS039601",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "TX",
"license": "28871",
"primary": true
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "IA",
"license": "DDS-09265",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3459224-01",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3459224-02",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3459224-04",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3459224-03",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Mansfield, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.