Omowumi Akhuini Ihionkhan, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

20172 Issued in TX

Practice address

1499 E Marshall Ave
Longview, TX 75601-5433

Phone

(903) 242-9778

Fax

(903) 242-9778

NPI assigned

Sep 28, 2006

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

Enrolled in TX

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Alpha First Dental Clinic P.a

  • General Practice Dentistry
  • Marshall, TX
  • NPI 1699403584
  NPD (past) Authorized official
• Alpha First Dental Clinic P.a

  • General Practice Dentistry
  • Longview, TX
  • NPI 1720269707
  NPD (past) Authorized official

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595980800000",
    "number": "1396836623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1499 E MARSHALL AVE",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756016814",
            "telephone_number": "903-242-9777",
            "fax_number": "903-212-4210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1499 E MARSHALL AVE",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756015433",
            "telephone_number": "903-242-9778",
            "fax_number": "903-242-9778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IHIONKHAN",
        "first_name": "OMOWUMI",
        "middle_name": "AKHUINI",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-28",
        "last_updated": "2020-07-29",
        "certification_date": "2020-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "20172",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "154847101",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cuc Linh Thi Huynh, RPH
• Ngoc Tran Bao Huynh, PHARMACIST
• I E Willis Jr DPM PC
• Elena Iglehart, MD
• Christopher E Ihionkhan, M.D.
• IHS Acquisition No 138 Inc
• Beverly K Iltis, PA
• Impel Ambulance Service, Inc
• Inform Diagnostics, Inc
• Lena Brittany Ingraham, PPCNP-BC, FNP-C

• General Practice Dentistry in Longview, TX
• Providers in Longview, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2020; 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.

Verify at the official NPI Registry.