Olivia Joelle Ndoutoume, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

32576 Issued in TX

Practice address

2801 Bill Owens Pkwy
Apt 279
Longview, TX 75605-2115

Phone

(650) 307-7135

NPI assigned

Sep 2, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in VT

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Pearl Dental PLLC

  • General Practice Dentistry
  • Hallsville, TX
  • NPI 1568107589
  NPD Authorized official

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

{
    "created_epoch": "1472774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650240000000",
    "number": "1154878551",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2539 JUDSON RD",
            "address_2": "KOOL SMILES",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756054643",
            "telephone_number": "650-307-7135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2801 BILL OWENS PKWY",
            "address_2": "APT 279",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756052115",
            "telephone_number": "650-307-7135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NDOUTOUME",
        "first_name": "OLIVIA",
        "middle_name": "JOELLE",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-02",
        "last_updated": "2022-04-18",
        "certification_date": "2022-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "32576",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Khurram Nawab
• Krishna Reddy Nayini, M.D.
• Nithin Reddy Nayini, M.D.
• Rama Devi Nayini, M.D.
• Funwie Calvin Nchibnjong, PHARMD
• Tagbo Charles Nduka, M.D.
• Elaine Neagle, LCDC
• Savanna L Neal, LCDC
• Kristi Nealy, P.A.
• Nec Longview Emergency Center, LP

• General Practice Dentistry in Longview, TX
• Providers in Longview, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.