Active NPI
Anthony C. Okoli, DMD, MPH
- Dentist
- Chicago, IL
National Provider Identifier
1386054310
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 30783
- Practice address
- 811 W Wellington Ave
Chicago, IL 60657-5123 - Phone
- (773) 975-1600
- NPI assigned
- Apr 29, 2014
- Last updated
- Jan 14, 2016
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 30783 | TX | Primary |
| Student in an Organized Health Care Education/Training Program | 390200000X | NU |
Addresses
Primary practice location
811 W Wellington Ave
Chicago, IL 60657-5123
Mailing address
5230 Griggs Rd
Houston, TX 77021-3760
Phone (562) 305-8206
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160120000548 | TX | Order and Referring Only - Dentist | 2668775925 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1398729600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1452729600000",
"number": "1386054310",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5230 GRIGGS RD",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770213760",
"telephone_number": "562-305-8206"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "811 W WELLINGTON AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606575123",
"telephone_number": "773-975-1600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OKOLI",
"first_name": "ANTHONY",
"middle_name": "C.",
"name_prefix": "Dr.",
"credential": "DMD, MPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-04-29",
"last_updated": "2016-01-14",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "TX",
"license": "30783",
"primary": true
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "NU",
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.