Active NPI
Omotola Ugochuku, DMD
- Dentist
- Berlin, NJ
National Provider Identifier
1821275264
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DS0379019
- Practice address
- 339 N Route 73
Suite 4
Berlin, NJ 08009-9707 - Phone
- (856) 753-1547
- Fax
- (856) 753-1548
- NPI assigned
- Jan 29, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DS0379019 | PA | Primary |
Addresses
Primary practice location
339 N Route 73
Suite 4
Berlin, NJ 08009-9707
Mailing address
339 N Route 73
Suite 4
Berlin, NJ 08009-9707
Phone (856) 753-1547
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DS0379019 | PA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1201564800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1201564800000",
"number": "1821275264",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "339 N ROUTE 73",
"address_2": "SUITE 4",
"city": "BERLIN",
"state": "NJ",
"postal_code": "080099707",
"telephone_number": "856-753-1547",
"fax_number": "856-753-1548"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "339 N ROUTE 73",
"address_2": "SUITE 4",
"city": "BERLIN",
"state": "NJ",
"postal_code": "080099707",
"telephone_number": "856-753-1547",
"fax_number": "856-753-1548"
}
],
"practiceLocations": [],
"basic": {
"last_name": "UGOCHUKU",
"first_name": "OMOTOLA",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-01-29",
"last_updated": "2008-01-29",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "PA",
"license": "DS0379019",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Berlin, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.