Individual provider Active NPI

Deborah Linda Owusu

  • General Practice Dentistry
  • Durham, NC
National Provider Identifier
1124768288
Registry record updated Sep 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
12893 Issued in NC
Practice address
1301 Fayetteville St
Durham, NC 27707-2398
Phone
(919) 956-4000
NPI assigned
Mar 29, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 29, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 12893 NC Primary

Addresses

Primary practice location

1301 Fayetteville St
Durham, NC 27707-2398

Mailing address

1301 Fayetteville St
Durham, NC 27707-2325

Other practice location 1

136 Greenville Blvd SW
Greenville, NC 27858
Phone (252) 931-8232

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
I20230905003522 NC Practitioner - Dentist 3577926799 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Lincoln Community Health Center Incorporated CurrentSince Aug 28, 2023 Accepting new patients
Lincoln Community Health Center Incorporated CurrentSince Aug 28, 2023 Accepting new patients

Locations

1301 Fayetteville St
Durham, NC 27707
Phone (919) 956-4000

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": "1648512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695945600000",
    "number": "1124768288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 FAYETTEVILLE ST",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277072325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 FAYETTEVILLE ST",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277072398",
            "telephone_number": "919-956-4000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "136 Greenville Blvd SW",
            "address_purpose": "LOCATION",
            "city": "Greenville",
            "state": "NC",
            "postal_code": "27858",
            "country_code": "US",
            "telephone_number": "252-931-8232",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OWUSU",
        "first_name": "DEBORAH",
        "middle_name": "LINDA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-03-29",
        "last_updated": "2023-09-29",
        "certification_date": "2023-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "12893",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Durham, NC

Sources for this page

Verify at the official NPI Registry.