Individual provider Active NPI

Kelechi Ononauju Okereke, DDS

  • Pediatric Dentistry
  • Danville, VA
National Provider Identifier
1386261097
Registry record updated Jun 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
0401418328 Issued in VA
Practice address
Piedmont Access to Health Services
116 S Ridge Street
Danville, VA 24541-0001
Phone
(434) 791-3630
Fax
(434) 791-4088
NPI assigned
Jun 29, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X 0401418328 VA Primary

Addresses

Primary practice location

Piedmont Access to Health Services
116 S Ridge Street
Danville, VA 24541-0001

Mailing address

102 Tandy CT
Jamestown, NC 27282-9739
Phone (919) 353-3445

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
I20230623002208 VA Practitioner - Dentist 5496112054 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Piedmont Access to Health Services, Inc CurrentSince Jun 1, 2023 Accepting new patients
Piedmont Access to Health Services Inc CurrentSince Jun 1, 2023 Accepting new patients
Piedmont Access to Health Services, Inc Current Accepting new patients

Locations

380 Washington St
Boydton, VA 23917
Phone (434) 738-6102

30 S Main St
Chatham, VA 24531
Phone (434) 432-4443

705 Main St
Danville, VA 24541
Phone (434) 791-4122

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1593388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718323200000",
    "number": "1386261097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 TANDY CT",
            "city": "JAMESTOWN",
            "state": "NC",
            "postal_code": "272829739",
            "telephone_number": "919-353-3445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PIEDMONT ACCESS TO HEALTH SERVICES",
            "address_2": "116 S RIDGE STREET",
            "city": "DANVILLE",
            "state": "VA",
            "postal_code": "245410001",
            "telephone_number": "434-791-3630",
            "fax_number": "434-791-4088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OKEREKE",
        "first_name": "KELECHI",
        "middle_name": "ONONAUJU",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-06-29",
        "last_updated": "2024-06-14",
        "certification_date": "2024-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "VA",
            "license": "0401418328",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Danville, VA

Sources for this page

Verify at the official NPI Registry.