Kingsley Momodu, DDS & Associates, PLLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

#9234 Issued in NC

Legal business name

KINGSLEY MOMODU, DDS & ASSOCIATES, PLLC

Practice address

2901 Breezewood Ave
Suite 101
Fayetteville, NC 28303-5409

Phone

(443) 762-1987

NPI assigned

Oct 6, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Kingsley Oise Momodu, DDSNPI 1285919902

Title

Dental Surgeon/Proprietor

Phone

(443) 762-1987

Specialties & licenses 1

Addresses

Other names 1

• Brite Care Dental Other name

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kingsley Oise Momodu, D.D.S.

  • Dentist
  • Fayetteville, NC
  • NPI 1285919902
  NPD Authorized official

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

{
    "created_epoch": "1349481600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1683763200000",
    "number": "1801148457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2901 BREEZEWOOD AVE",
            "address_2": "SUITE 101",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283035409",
            "telephone_number": "443-762-1987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2901 BREEZEWOOD AVE",
            "address_2": "SUITE 101",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283035409",
            "telephone_number": "443-762-1987"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KINGSLEY MOMODU, DDS & ASSOCIATES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-06",
        "last_updated": "2023-05-11",
        "certification_date": "2023-05-11",
        "status": "A",
        "authorized_official_last_name": "MOMODU",
        "authorized_official_first_name": "KINGSLEY",
        "authorized_official_middle_name": "OISE",
        "authorized_official_title_or_position": "DENTAL SURGEON/PROPRIETOR",
        "authorized_official_telephone_number": "443-762-1987",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NC",
            "license": "#9234",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brite Care Dental",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Brite Care Dental",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Tywanda King
• Valorie Wynette King, PHD
• Yvonne M King, MSSW
• Michael Joseph Kingberg, DO
• Kingdom Logistics Group, LLC (Transformative Family Counseling Services)
• Joyce Amaris Kinney
• Caroline Herring Kinsey, AU.D
• Theresa Kinzel, OTR
• Esther K Kiraya
• Stephanie Lynn Kirby, MD

• Dental Clinic/Center in Fayetteville, NC
• Providers in Fayetteville, NC by specialty
• Dental Clinic/Center in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2023; 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.