Individual provider Active NPI

Chinatu P Ego-Osuala, D.D.S

  • General Practice Dentistry
  • Takoma Park, MD
National Provider Identifier
1144516329
Registry record updated Nov 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
15803 Issued in MD
Practice address
7610 Carroll Ave
480
Takoma Park, MD 20912-6384
Phone
(301) 326-1302
Fax
(301) 326-1092
NPI assigned
Jun 25, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 20, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
General Practice Dentistry 1223G0001X 15803 MD Primary

Addresses

Primary practice location

7610 Carroll Ave
480
Takoma Park, MD 20912-6384

Mailing address

7610 Carroll Ave
480
Takoma Park, MD 20912-6384
Phone (301) 326-1302

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

LicenseStateTypeSpecialty
15803MDMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1308960000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732060800000",
    "number": "1144516329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7610 CARROLL AVE",
            "address_2": "480",
            "city": "TAKOMA PARK",
            "state": "MD",
            "postal_code": "209126384",
            "telephone_number": "301-326-1302",
            "fax_number": "301-326-1092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7610 CARROLL AVE",
            "address_2": "480",
            "city": "TAKOMA PARK",
            "state": "MD",
            "postal_code": "209126384",
            "telephone_number": "301-326-1302",
            "fax_number": "301-326-1092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EGO-OSUALA",
        "first_name": "CHINATU",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-06-25",
        "last_updated": "2024-11-20",
        "certification_date": "2024-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MD",
            "license": "15803",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Takoma Park, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2024; 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.