Individual provider Active NPI

Kevin Okoli

  • Dentist
  • Jbsa Lackland, TX
National Provider Identifier
1780514828
Registry record updated Aug 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
14296179-9926 Issued in UT
Practice address
1615 Truemper St BLDG 6418
Jbsa Lackland, TX 78236-5511
Phone
(210) 292-0673
NPI assigned
May 20, 2026
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 14296179-9926 UT Primary

Addresses

Primary practice location

1615 Truemper St BLDG 6418
Jbsa Lackland, TX 78236-5511

Mailing address

1615 Truemper St BLDG 6418
Jbsa Lackland, TX 78236-5511
Phone (210) 292-0673

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

NPI Registry JSON

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

{
    "created_epoch": "1779235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787011200000",
    "number": "1780514828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1615 TRUEMPER ST BLDG 6418",
            "city": "JBSA LACKLAND",
            "state": "TX",
            "postal_code": "782365511",
            "telephone_number": "210-292-0673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1615 TRUEMPER ST BLDG 6418",
            "city": "JBSA LACKLAND",
            "state": "TX",
            "postal_code": "782365511",
            "telephone_number": "210-292-0673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OKOLI",
        "first_name": "KEVIN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-05-20",
        "last_updated": "2026-08-18",
        "certification_date": "2026-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "UT",
            "license": "14296179-9926",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jbsa Lackland, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2026; 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.