Blossom Amechi

Primary specialty

DentistTaxonomy code 122300000X

License

62240 Issued in KS

Practice address

10333 E 21St St N Ste 101
Wichita, KS 67206-3544

Phone

(316) 684-1470

NPI assigned

Apr 24, 2024

Sex

Female

Sole proprietor

Yes

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Feb 25, 2025.

{
    "created_epoch": "1713916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740441600000",
    "number": "1831945443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10333 E 21ST ST N STE 101",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672063544",
            "telephone_number": "316-684-1470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10333 E 21ST ST N STE 101",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672063544",
            "telephone_number": "316-684-1470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMECHI",
        "first_name": "BLOSSOM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-04-24",
        "last_updated": "2025-02-25",
        "certification_date": "2025-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QS1000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Student Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "KS",
            "license": "62240",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2025; 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.