Individual provider Active NPI

Waka Kadoma, D.D.S., M.S.

  • Periodontics
  • Chapel Hill, NC
National Provider Identifier
1124103841
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
6914 Issued in NC
Practice address
1525 E Franklin St
Suite 2
Chapel Hill, NC 27514-2811
Phone
(919) 928-9392
Fax
(919) 968-1025
NPI assigned
Oct 25, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X 6914 NC Primary

Addresses

Primary practice location

1525 E Franklin St
Suite 2
Chapel Hill, NC 27514-2811

Mailing address

1525 E Franklin St
Suite 2
Chapel Hill, NC 27514-2811
Phone (919) 928-9392

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)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
6914NCMDPeriodontist

NPI Registry JSON

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1124103841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1525 E FRANKLIN ST",
            "address_2": "SUITE 2",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275142811",
            "telephone_number": "919-928-9392",
            "fax_number": "919-968-1025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1525 E FRANKLIN ST",
            "address_2": "SUITE 2",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275142811",
            "telephone_number": "919-928-9392",
            "fax_number": "919-968-1025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KADOMA",
        "first_name": "WAKA",
        "name_prefix": "Dr.",
        "credential": "D.D.S., M.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "NC",
            "license": "6914",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chapel Hill, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.