Individual provider Active NPI

Emmanuel Acheampong, D.M.D

  • Pediatric Dentistry
  • Vero Beach, FL
National Provider Identifier
1407122252
Registry record updated Nov 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
DN20688 Issued in FL
Practice address
1545 9TH St SW
Vero Beach, FL 32962-4312
Phone
(772) 257-8224
Fax
(772) 571-1602
NPI assigned
Mar 27, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Pediatric Dentistry 1223P0221X DN20688 FL Primary

Addresses

Primary practice location

1545 9TH St SW
Vero Beach, FL 32962-4312

Mailing address

1545 9TH St SW
Vero Beach, FL 32962-4312
Phone (772) 257-8224

Other identifiers 1

IdentifierTypeStateIssuer
012427700MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DN20688FLMDPediatric Dentist

NPI Registry JSON

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

{
    "created_epoch": "1332806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415145600000",
    "number": "1407122252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1545 9TH ST SW",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329624312",
            "telephone_number": "772-257-8224",
            "fax_number": "772-571-1602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1545 9TH ST SW",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329624312",
            "telephone_number": "772-257-8224",
            "fax_number": "772-571-1602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ACHEAMPONG",
        "first_name": "EMMANUEL",
        "name_prefix": "Dr.",
        "credential": "D.M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-03-27",
        "last_updated": "2014-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "FL",
            "license": "DN20688",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "012427700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vero Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2014; 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.