Individual provider Active NPI

Nana Yaa Opokuaddo, DDS, BDS, MBA

  • General Practice Dentistry
  • Columbus, OH
National Provider Identifier
1790190130
Registry record updated Jan 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
0401414494 Issued in VA
Practice address
2697 Cleveland Ave
Columbus, OH 43211-1663
Phone
(614) 268-1243
Fax
(614) 407-8482
NPI assigned
Jun 24, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 30024333 OH
General Practice Dentistry 1223G0001X 0401414494 VA Primary

Addresses

Primary practice location

2697 Cleveland Ave
Columbus, OH 43211-1663

Mailing address

2697 Cleveland Ave
Columbus, OH 43211-1663
Phone (614) 268-1243

Other names 1

  • Dr. Nana Yaa Saah Poku Former name

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
Credentials
Master of Business Administration

State licenses

LicenseStateTypeSpecialty
30024333OHMDGeneral Practice Dentistry
0401414494VAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1403568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609977600000",
    "number": "1790190130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2697 CLEVELAND AVE",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432111663",
            "telephone_number": "614-268-1243",
            "fax_number": "614-407-8482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2697 CLEVELAND AVE",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432111663",
            "telephone_number": "614-268-1243",
            "fax_number": "614-407-8482"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OPOKUADDO",
        "first_name": "NANA YAA",
        "name_prefix": "Dr.",
        "credential": "DDS, BDS, MBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-24",
        "last_updated": "2021-01-07",
        "certification_date": "2021-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "30024333",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401414494",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NANA YAA",
            "last_name": "POKU",
            "middle_name": "SAAH",
            "prefix": "DR.",
            "credential": "BDS, MBA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Columbus, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2021; 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.