Dorrette Jon Ibazebo, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

8686 Issued in NC

Practice address

6425 Old Plank Rd
Suite 102
High Point, NC 27265-3277

Phone

(336) 886-1747

NPI assigned

Sep 11, 2008

Last updated

Dec 15, 2011By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Dr J Mark Oliver PLLC

  dba North Point Dental Associates

  • Dental Clinic/Center
  • High Point, NC
  • NPI 1467504852
  NPD (past)

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

{
    "created_epoch": "1221091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323907200000",
    "number": "1366691651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7109 HORSEMAN CT",
            "city": "SUMMERFIELD",
            "state": "NC",
            "postal_code": "273589293",
            "telephone_number": "336-788-6070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6425 OLD PLANK RD",
            "address_2": "SUITE 102",
            "city": "HIGH POINT",
            "state": "NC",
            "postal_code": "272653277",
            "telephone_number": "336-886-1747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IBAZEBO",
        "first_name": "DORRETTE",
        "middle_name": "JON",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-11",
        "last_updated": "2011-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NC",
            "license": "8686",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5910831",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ashley Jess Hussong, MCD, CCC-A
• Benjamin Timothy Hutchison, MD
• William Neal Hutto, OD
• Rachel Anne Hutton-Orr, PA-C
• Karen T. Hyneck, LCMHC
• John Brent Idol
• Kim Weldon Idol, PT
• Benjamin Maduakonam Igwemezie, M.D.
• Shehab Foiz Imam, DO
• Jennifer K Incillo

• Dentist in High Point, NC
• Providers in High Point, NC by specialty
• Dentist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2011; 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.