Active NPI
Chidi Ezeokoli, DDS
- Dentist
- Richmond, TX
National Provider Identifier
1578299178
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 37808
- Practice address
- 10177 W Grand Pkwy S Ste 103
Richmond, TX 77407-8682 - Phone
- (346) 702-3085
- NPI assigned
- Jul 26, 2022
- Last updated
- Jul 26, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 37808 | TX | Primary |
Addresses
Primary practice location
10177 W Grand Pkwy S Ste 103
Richmond, TX 77407-8682
Mailing address
3008 Fairdale Estates CT
Houston, TX 77057-2374
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 |
|---|---|---|---|---|
| I20221118001366 | TX | Order and Referring Only - Dentist | 8123496304 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 38708 | TX | MD | Counseling Psychologist |
| 37808 | TX | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dentists of Fort Bend, PC | Dentist | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1658793600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658793600000",
"number": "1578299178",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3008 FAIRDALE ESTATES CT",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770572374"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10177 W GRAND PKWY S STE 103",
"city": "RICHMOND",
"state": "TX",
"postal_code": "774078682",
"telephone_number": "346-702-3085"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EZEOKOLI",
"first_name": "CHIDI",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-07-26",
"last_updated": "2022-07-26",
"certification_date": "2022-05-31",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "TX",
"license": "37808",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Richmond, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2022; 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.