Adaeze Stephanie Nkemdirim

Primary specialty

DentistTaxonomy code 122300000X

License

060931 Issued in NY

Practice address

1 Gustave L Levy PL
New York, NY 10029-6504

Phone

(212) 423-4500

Fax

(212) 289-0126

NPI assigned

Apr 24, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1524528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590710400000",
    "number": "1790273910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 GUSTAVE L LEVY PL",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100296504",
            "telephone_number": "212-423-4500",
            "fax_number": "212-289-0126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 GUSTAVE L LEVY PL",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100296504",
            "telephone_number": "212-423-4500",
            "fax_number": "212-289-0126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NKEMDIRIM",
        "first_name": "ADAEZE",
        "middle_name": "STEPHANIE",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-04-24",
        "last_updated": "2020-05-29",
        "certification_date": "2020-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "060931",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Praise Njoku Austin, MD
• Bamidele Njoku, ACNP
• Edidiong Okokon Njoku
• NK-Chelsea Eyewear Inc. (Native Ken)
• Hilda Nkansah, FNP-BC
• NKG Mental Health Counseling, PLLC
• Ingrid Nkongho, PSYD
• Dayana Nkrumah
• NKS Pharmacy Inc (Whitney Chemist)
• Daniella Nkurunziza, MHC-LP

• Dentist in New York, NY
• Providers in New York, NY by specialty
• Dentist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.