Kelvin Chukwuemeka Imo, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

32536 Issued in TX

Practice address

2111 Limrick Dr
Pearland, TX 77581-5143

Phone

(301) 404-9633

NPI assigned

Oct 28, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Imo Sleep Solutions LLC

  • Customized Equipment (DME)
  • Friendswood, TX
  • NPI 1487258208
  NPD Authorized official

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

{
    "created_epoch": "1225152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492041600000",
    "number": "1750534228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2111 LIMRICK DR",
            "city": "PEARLAND",
            "state": "TX",
            "postal_code": "775815143",
            "telephone_number": "301-404-9633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2111 LIMRICK DR",
            "city": "PEARLAND",
            "state": "TX",
            "postal_code": "775815143",
            "telephone_number": "301-404-9633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IMO",
        "first_name": "KELVIN",
        "middle_name": "CHUKWUEMEKA",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-10-28",
        "last_updated": "2017-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "32536",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1750534228",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joseph Bryan Ilustre, D.D.S
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• Imed Consultants PLLC
• Immaculate Home Health, Inc
• In Phase Neuro, PLLC
• In Que Lab Services L.L.C.
• Inclusive Psychiatry LLC
• Independent Pharmacy Services,LLC (Live Rite Pharmacy)
• Eneida Infante, CPHT

• General Practice Dentistry in Pearland, TX
• Providers in Pearland, 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 Apr 13, 2017; 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.