Aiyevbekpen Omo-Okhuasuyi

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

37989 Issued in TX

Practice address

432 S Bibb Ave Ste 300
Eagle Pass, TX 78852-5390

Phone

(409) 203-9562

NPI assigned

Nov 2, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1635811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635811200000",
    "number": "1609531839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9827 MARBACH CRST",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782454476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "432 S BIBB AVE STE 300",
            "city": "EAGLE PASS",
            "state": "TX",
            "postal_code": "788525390",
            "telephone_number": "409-203-9562"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OMO-OKHUASUYI",
        "first_name": "AIYEVBEKPEN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-11-02",
        "last_updated": "2021-11-02",
        "certification_date": "2021-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "37989",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Eagle Pass, TX
• Providers in Eagle Pass, 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 Nov 2, 2021; 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.