Active NPI
Chukwujindu Onyemordi Nwaigbo, DDS
- General Practice Dentistry
- Saint Paul, MN
National Provider Identifier
1205289428
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- D13741
- Practice address
- 476 Herschel St
Apt 1
Saint Paul, MN 55104-3608 - Phone
- (832) 512-2448
- NPI assigned
- Jul 22, 2016
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | D13741 | MN | Primary |
Addresses
Primary practice location
476 Herschel St
Apt 1
Saint Paul, MN 55104-3608
Mailing address
476 Herschel St
Apt 1
Saint Paul, MN 55104-3608
Phone (832) 512-2448
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20161103000899 | GA | Order and Referring Only - Other (Non-Physician) | 4789962226 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D13741 | MN | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1469145600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1469145600000",
"number": "1205289428",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "476 HERSCHEL ST",
"address_2": "APT 1",
"city": "SAINT PAUL",
"state": "MN",
"postal_code": "551043608",
"telephone_number": "832-512-2448"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "476 HERSCHEL ST",
"address_2": "APT 1",
"city": "SAINT PAUL",
"state": "MN",
"postal_code": "551043608",
"telephone_number": "832-512-2448"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NWAIGBO",
"first_name": "CHUKWUJINDU",
"middle_name": "ONYEMORDI",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-07-22",
"last_updated": "2016-07-22",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MN",
"license": "D13741",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Paul, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2016; 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.