Individual provider Active NPI

Andrew Onyejiuwa, DMD

  • Oral and Maxillofacial Surgery (Dentist)
  • Brooklyn, NY
National Provider Identifier
1619002912
Registry record updated Jun 2, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
054775 Issued in NY
Practice address
465 E 7TH St Apt 3B
Brooklyn, NY 11218-4844
Phone
(857) 891-5288
NPI assigned
Feb 23, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 2, 2017

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 50 054775 NY
General Practice Dentistry 1223G0001X 21604 MA
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 054775 NY Primary

Addresses

Primary practice location

465 E 7TH St Apt 3B
Brooklyn, NY 11218-4844

Mailing address

465 E 7TH St Apt 3B
Brooklyn, NY 11218-4844
Phone (857) 891-5288

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20170501002289 NY Practitioner - Oral Surgery 6709163660 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
50 054775NYMDDentist
21604MAMDGeneral Practice Dentistry
054775NYMDOral and Maxillofacial Surgery (Dentist)

Practice roles

OrganizationSpecialtyStatusNew patients
Bronxcare Health System CurrentSince Apr 21, 2017 Accepting new patients
Bronxcare Health System CurrentSince Apr 21, 2017 Accepting new patients

Locations

1276 Fulton Ave
Rm 208
Bronx, NY 10456
Phone (718) 901-8918

1650 Grand Concourse
Bronx, NY 10457
Phone (718) 294-7104

1276 Fulton Ave
Bronx, NY 10456
Phone (718) 518-5000

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722

Organizations & group practices 2

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": "1172188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1496361600000",
    "number": "1619002912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "465 E 7TH ST APT 3B",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112184844",
            "telephone_number": "857-891-5288",
            "fax_number": "718-599-4912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "465 E 7TH ST APT 3B",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112184844",
            "telephone_number": "857-891-5288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ONYEJIUWA",
        "first_name": "ANDREW",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-23",
        "last_updated": "2017-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "50 054775",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "21604",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NY",
            "license": "054775",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.