Individual provider Active NPI

Diamond Oluchi Enyinnia, DDS

  • General Practice Dentistry
  • Brookhaven, GA
National Provider Identifier
1235814864
Registry record updated Mar 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN123397 Issued in GA
Practice address
3103 Clairmont Rd NE Ste C
Brookhaven, GA 30329-1043
Phone
(404) 942-0086
NPI assigned
Jun 20, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 24, 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 DN123397 GA Primary

Addresses

Primary practice location

3103 Clairmont Rd NE Ste C
Brookhaven, GA 30329-1043

Mailing address

11523 Bob White Dr
Houston, TX 77035-2203
Phone (713) 269-1264

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
DN123397GAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
The Good Samaritan Health Center, Inc. PastSince Jun 1, 2023 Accepting new patients
Hope First Investments PastSince Jun 1, 2023 Accepting new patients

Organizations & group practices 2

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": "1687219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742774400000",
    "number": "1235814864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11523 BOB WHITE DR",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770352203",
            "telephone_number": "713-269-1264"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3103 CLAIRMONT RD NE STE C",
            "city": "BROOKHAVEN",
            "state": "GA",
            "postal_code": "303291043",
            "telephone_number": "404-942-0086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENYINNIA",
        "first_name": "DIAMOND",
        "middle_name": "OLUCHI",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-06-20",
        "last_updated": "2025-03-24",
        "certification_date": "2025-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN123397",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookhaven, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2025; 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.