Active NPI
Chinwendu Calis Nnagbo, DDS
- General Practice Dentistry
- Smyrna, GA
National Provider Identifier
1255069472
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 0401418125
- Practice address
- 2900 S Cobb Dr SE
Smyrna, GA 30080-7859 - Phone
- (470) 412-1981
- NPI assigned
- Aug 15, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DN123337 | GA | |
| General Practice Dentistry | 1223G0001X | 0401418125 | VA | Primary |
Addresses
Primary practice location
2900 S Cobb Dr SE
Smyrna, GA 30080-7859
Mailing address
2900 S Cobb Dr SE
Smyrna, GA 30080-7859
Phone (470) 412-1981
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
| License | State | Type | Specialty |
|---|---|---|---|
| DN123337 | GA | MD | General Practice Dentistry |
| 0401418125 | VA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1660521600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1721779200000",
"number": "1255069472",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2900 S COBB DR SE",
"city": "SMYRNA",
"state": "GA",
"postal_code": "300807859",
"telephone_number": "470-412-1981"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2900 S COBB DR SE",
"city": "SMYRNA",
"state": "GA",
"postal_code": "300807859",
"telephone_number": "470-412-1981"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NNAGBO",
"first_name": "CHINWENDU",
"middle_name": "CALIS",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-08-15",
"last_updated": "2024-07-24",
"certification_date": "2024-07-24",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "GA",
"license": "DN123337",
"primary": false
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "VA",
"license": "0401418125",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Smyrna, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.