Active NPI
Evi Addoh
- Dentist
- Valdosta, GA
National Provider Identifier
1750027728
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DN122776
- Practice address
- 1609 Norman Dr Ste B
Valdosta, GA 31601-3753 - Phone
- (229) 269-4607
- NPI assigned
- May 11, 2022
- Last updated
- Jul 13, 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DN122776 | GA | Primary |
| Student in an Organized Health Care Education/Training Program | 390200000X |
Addresses
Primary practice location
1609 Norman Dr Ste B
Valdosta, GA 31601-3753
Mailing address
4750 Mac Rd Apt B8
Valdosta, GA 31605-6392
Phone (662) 543-0519
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN122776 | GA | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Purple Dental LLC | 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": "1652227200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1657670400000",
"number": "1750027728",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4750 MAC RD APT B8",
"city": "VALDOSTA",
"state": "GA",
"postal_code": "316056392",
"telephone_number": "662-543-0519"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1609 NORMAN DR STE B",
"city": "VALDOSTA",
"state": "GA",
"postal_code": "316013753",
"telephone_number": "229-269-4607"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ADDOH",
"first_name": "EVI",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-05-11",
"last_updated": "2022-07-13",
"certification_date": "2022-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "GA",
"license": "DN122776",
"primary": true
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Valdosta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.