Individual provider Active NPI

Amen Alemayehu

  • Dentist
  • Virginia Beach, VA
National Provider Identifier
1275812190
Registry record updated Jul 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
0401413304 Issued in VA
Practice address
904 Kempsville Rd
Virginia Beach, VA 23464-5571
Phone
(804) 267-0087
NPI assigned
Aug 9, 2011
Last updated
Jul 25, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 0401413304 VA Primary

Addresses

Primary practice location

904 Kempsville Rd
Virginia Beach, VA 23464-5571

Mailing address

210 Meadow View Blvd
Suffolk, VA 23435-3495
Phone (757) 673-6263

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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

Enrollment IDStateProvider typePAC IDDetails
I20160902000572 VA Order and Referring Only - DentistPractitioner - Dentist 3577859354

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0401413304VAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Lefcoe,Weinstein,Sachs,Schiff Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1312848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1469404800000",
    "number": "1275812190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 MEADOW VIEW BLVD",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234353495",
            "telephone_number": "757-673-6263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "904 KEMPSVILLE RD",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234645571",
            "telephone_number": "804-267-0087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALEMAYEHU",
        "first_name": "AMEN",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-09",
        "last_updated": "2016-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401413304",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

Verify at the official NPI Registry.