Individual provider Active NPI

Ifeatu Chikaodili Nnebe, DDS

  • General Practice Dentistry
  • Folsom, CA
National Provider Identifier
1184091571
Registry record updated May 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
65052 Issued in CA
Practice address
4257 Emerald Gate LN
Folsom, CA 95630-6066
Phone
(916) 294-5219
NPI assigned
Sep 1, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 26, 2025

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 65052 CA Primary

Addresses

Primary practice location

4257 Emerald Gate LN
Folsom, CA 95630-6066

Mailing address

4257 Emerald Gate LN
Folsom, CA 95630-6066
Phone (916) 294-5219

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20160411002178 CA Practitioner - Oral Surgery 2668770439 Reassigns benefits to 1 organization
I20250219003753 TX Practitioner - Dentist 2668770439 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Health and Life Organization, Inc. General Practice CurrentSince Feb 23, 2016 Accepting new patients
Northern Valley Indian Health Inc CurrentSince Feb 18, 2025 Accepting new patients
Health and Life Organization, Inc CurrentSince Feb 23, 2016 Accepting new patients
Ifeatu Nnebe DDS Inc Current Accepting new patients
Northern Valley Indian Health Inc CurrentSince Feb 18, 2025 Accepting new patients

Locations

1990 Concord Ave
Chico, CA 95928
Phone (530) 809-3300

3030 Explorer Dr
Sacramento, CA 95827
Phone (916) 642-1885

7275 E Southgate Dr
Ste 204
Sacramento, CA 95823
Phone (916) 428-3788

5524 Assembly Ct
Sacramento, CA 95823
Phone (916) 642-1880

2138 Del Paso Blvd
Sacramento, CA 95815
Phone (916) 428-3788

207 N Butte St
Willows, CA 95988
Phone (530) 934-4641

Interoperability endpoints

  • Direct secure messaging: ifeatu.nnebe.p1@direct.mathiesenmemorialhc.nextgenshare.com

Organizations & group practices 5

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": "1441065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748217600000",
    "number": "1184091571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4257 EMERALD GATE LN",
            "city": "FOLSOM",
            "state": "CA",
            "postal_code": "956306066",
            "telephone_number": "916-294-5219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4257 EMERALD GATE LN",
            "city": "FOLSOM",
            "state": "CA",
            "postal_code": "956306066",
            "telephone_number": "916-294-5219"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NNEBE",
        "first_name": "IFEATU",
        "middle_name": "CHIKAODILI",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-01",
        "last_updated": "2025-05-26",
        "certification_date": "2025-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "65052",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Folsom, CA

Sources for this page

Verify at the official NPI Registry.