Active NPI
Kachikwulu Chukwuemeka Ikem, DDS
- Dentist
- El Paso, TX
National Provider Identifier
1831409366
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 25820
- Practice address
- 3590 N Zaragoza Rd Ste 105-106
El Paso, TX 79938-8009 - Phone
- (915) 855-4444
- Fax
- (915) 990-2002
- NPI assigned
- Oct 18, 2010
- Sex
- Male
- 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 | 25820 | TX | Primary |
Addresses
Primary practice location
3590 N Zaragoza Rd Ste 105-106
El Paso, TX 79938-8009
Mailing address
3200 S Lancaster Rd Ste 760
Dallas, TX 75216-8823
Phone (214) 375-4100
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 |
|---|---|---|---|
| 25820 | TX | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| South Texas Dental Associates, L.P. | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- General Practice Dentistry
- Dallas, TX
- NPI 1720206121
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1287360000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1622764800000",
"number": "1831409366",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3200 S LANCASTER RD STE 760",
"city": "DALLAS",
"state": "TX",
"postal_code": "752168823",
"telephone_number": "214-375-4100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3590 N ZARAGOZA RD STE 105-106",
"city": "EL PASO",
"state": "TX",
"postal_code": "799388009",
"telephone_number": "915-855-4444",
"fax_number": "915-990-2002"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IKEM",
"first_name": "KACHIKWULU",
"middle_name": "CHUKWUEMEKA",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-10-18",
"last_updated": "2021-06-04",
"certification_date": "2021-06-04",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "TX",
"license": "25820",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in El Paso, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 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.