Individual provider Active NPI

Sandra Onekhena, DMD

  • General Practice Dentistry
  • Fayetteville, NC
National Provider Identifier
1568069680
Registry record updated Oct 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
12055 Issued in NC
Practice address
912 Robeson St
Fayetteville, NC 28305-5614
Phone
(910) 485-6136
NPI assigned
Oct 1, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 12055 NC Primary

Addresses

Primary practice location

912 Robeson St
Fayetteville, NC 28305-5614

Mailing address

912 Robeson St
Fayetteville, NC 28305-5614

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20201019001718 NC Order and Referring Only - DentistPractitioner - Dentist 4284054966

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": "1601510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601596800000",
    "number": "1568069680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "912 ROBESON ST",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283055614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "912 ROBESON ST",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283055614",
            "telephone_number": "910-485-6136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ONEKHENA",
        "first_name": "SANDRA",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-01",
        "last_updated": "2020-10-02",
        "certification_date": "2020-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "12055",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

Verify at the official NPI Registry.