Bonaventure Chisom Nwokocha, D.D.S

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D12960 Issued in MN

Practice address

7960 Brooklyn Blvd
Brooklyn Park, MN 55445-2722

Phone

(763) 710-9937

Fax

(763) 710-9968

NPI assigned

May 22, 2011

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MN

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

Practice roles

Locations

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.

• Today'S Dental

  • General Practice Dentistry
  • Brooklyn Park, MN
  • NPI 1356749659
  NPD Authorized official
• Today'S Dental Rogers LLC

  • Dental Clinic/Center
  • Rogers, MN
  • NPI 1386372597
  NPD
• Today'S Dental St.Cloud SC

  • Point of Service
  • Brooklyn Park, MN
  • NPI 1174913339
  NPD (past)

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

{
    "created_epoch": "1306022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599609600000",
    "number": "1194018374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16420 57TH AVE N",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554463728",
            "telephone_number": "618-593-2130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7960 BROOKLYN BLVD",
            "city": "BROOKLYN PARK",
            "state": "MN",
            "postal_code": "554452722",
            "telephone_number": "763-710-9937",
            "fax_number": "763-710-9968"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4128 2nd St S",
            "address_purpose": "LOCATION",
            "city": "Saint Cloud",
            "state": "MN",
            "postal_code": "563013704",
            "country_code": "US",
            "telephone_number": "320-774-2557",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NWOKOCHA",
        "first_name": "BONAVENTURE",
        "middle_name": "CHISOM",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-05-22",
        "last_updated": "2020-09-09",
        "certification_date": "2020-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "D12960",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1356749659",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1174913339",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nurturing Minds Therapy Center L.L.C.
• Sylvia Nutall
• Lilian T Nwaokorie, PA-C
• Ngozi Nwaokorie
• Josephine Amaka Nwoke, MSW, LICSW
• Gloria Ijeoma Nwoye, RN
• Walter Ogetti Nyabere, NP
• Bailey Nygaard, RN
• Nyonguo Home Health Services LLC
• Oak Crest Ventures LLC

• General Practice Dentistry in Brooklyn Park, MN
• Providers in Brooklyn Park, MN by specialty
• General Practice Dentistry in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2020; 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.