Individual provider Active NPI

Samuel C Nwogu, D.D.S.

  • Oral and Maxillofacial Surgery (Dentist)
  • Newark, DE
National Provider Identifier
1598889438
Registry record updated Mar 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
G1-0001224 Issued in DE
Practice address
200 Biddle Ave Ste 214
Newark, DE 19702-3966
Phone
(302) 595-4642
Fax
(302) 595-4648
NPI assigned
Mar 17, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X G1-0001224 DE Primary

Addresses

Primary practice location

200 Biddle Ave Ste 214
Newark, DE 19702-3966

Mailing address

200 Biddle Ave Ste 214
Newark, DE 19702-3966
Phone (302) 595-4642

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE
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
I20120110000235 DE Practitioner - Oral Surgery 9537335765 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Christiana Care Health Services, Inc Current Accepting new patients
Christiana Care Health Services, Inc CurrentSince Dec 22, 2011 Accepting new patients
Christiana Care Health Services Inc CurrentSince Dec 22, 2011 Accepting new patients
Delaware Oral & Maxillofacial Surgery,LLC Oral and Maxillofacial Surgery Past Accepting new patients

Locations

501 W 14th St
#4154
Wilmington, DE 19801
Phone (302) 428-4175

501 W 14th St
Wilmington, DE 19801
Phone (302) 320-4411

Organizations & group practices 4

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": "1174089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522108800000",
    "number": "1598889438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 BIDDLE AVE STE 214",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197023966",
            "telephone_number": "302-595-4642",
            "fax_number": "302-595-4648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 BIDDLE AVE STE 214",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197023966",
            "telephone_number": "302-595-4642",
            "fax_number": "302-595-4648"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NWOGU",
        "first_name": "SAMUEL",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-17",
        "last_updated": "2018-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "DE",
            "license": "G1-0001224",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, DE

Sources for this page

Verify at the official NPI Registry.