Active NPI
Ibrahim Idoh, DENTAL HYGIENE
- Dental Assistant
- Fort Polk, LA
National Provider Identifier
1255299368
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Assistant
- Practice address
- 7223 Mississippi Avenue
BLDG 1561
Fort Polk, LA 71459-7435 - Phone
- (726) 780-1451
- NPI assigned
- Jan 15, 2026
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Dental Assistant | 126800000X | Primary |
Addresses
Primary practice location
7223 Mississippi Avenue
BLDG 1561
Fort Polk, LA 71459-7435
Mailing address
7223 Mississippi Avenue
BLDG 1561
Fort Polk, LA 71459-7435
Phone (726) 780-1451
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1768435200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1768435200000",
"number": "1255299368",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7223 MISSISSIPPI AVENUE",
"address_2": "BLDG 1561",
"city": "FORT POLK",
"state": "LA",
"postal_code": "714597435",
"telephone_number": "726-780-1451"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7223 MISSISSIPPI AVENUE",
"address_2": "BLDG 1561",
"city": "FORT POLK",
"state": "LA",
"postal_code": "714597435",
"telephone_number": "726-780-1451"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IDOH",
"first_name": "IBRAHIM",
"credential": "DENTAL HYGIENE",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2026-01-15",
"last_updated": "2026-01-15",
"certification_date": "2026-01-13",
"status": "A"
},
"taxonomies": [
{
"code": "126800000X",
"taxonomy_group": "",
"desc": "Dental Assistant",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Polk, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.