Individual provider Active NPI

Obianuju Okeke, DMD

  • Dentist
  • Brooklyn, NY
National Provider Identifier
1730703265
Registry record updated Dec 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
062115-01 Issued in NY
Practice address
834 Flatbush Ave
Brooklyn, NY 11226-3102
Phone
(718) 693-2577
NPI assigned
Jun 1, 2020
Last updated
Dec 6, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 6, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 062115-01 NY Primary
Student in an Organized Health Care Education/Training Program 390200000X NU

Addresses

Primary practice location

834 Flatbush Ave
Brooklyn, NY 11226-3102

Mailing address

834 Flatbush Ave
Brooklyn, NY 11226-3102
Phone (718) 901-8410

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
I20220829001487 NY Practitioner - Oral SurgeryPractitioner - Dentist 4385028117 Reassigns benefits to 5 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
062115-01NYMDDentist
062115NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
3545 Johnson Blvd Dental PC CurrentSince Jul 26, 2022 Accepting new patients
43 Chruch Street Dental PC CurrentSince Jun 18, 2022 Accepting new patients
Alejandro Williams Dental Office PC CurrentSince May 17, 2022 Accepting new patients
Bonita Sonrisa Dental Ipa CurrentSince Jun 8, 2022 Accepting new patients
Bonita Sonrisa Dental Mso CurrentSince Aug 11, 2022 Accepting new patients

Locations

759 4th Ave
Brooklyn, NY 11232
Phone (718) 832-1194

1810 Harriet St
Elmont, NY 11003
Phone (516) 354-3371

664 Academy St
New York, NY 10034
Phone (212) 567-2431

736 W 181st St
Apt 1I
New York, NY 10033
Phone (347) 681-1800

Organizations & group practices 6

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": "1590969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638748800000",
    "number": "1730703265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "834 FLATBUSH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112263102",
            "telephone_number": "718-901-8410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "834 FLATBUSH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112263102",
            "telephone_number": "718-693-2577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OKEKE",
        "first_name": "OBIANUJU",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-06-01",
        "last_updated": "2021-12-06",
        "certification_date": "2021-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "062115-01",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.