Individual provider Active NPI

David Onyirimba, DDS

  • General Practice Dentistry
  • Duluth, GA
National Provider Identifier
1902471105
Registry record updated May 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN122857 Issued in GA
Practice address
2730 Peachtree Industrial Blvd Ste 202
Duluth, GA 30097-8628
Phone
(678) 385-9355
NPI assigned
May 21, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 9, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
General Practice Dentistry 1223G0001X DN122857 GA Primary

Addresses

Primary practice location

2730 Peachtree Industrial Blvd Ste 202
Duluth, GA 30097-8628

Mailing address

650 Ponce de Leon Ave Ste. 300
1164
Atlanta, GA 30308-1804
Phone (860) 559-4795

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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

Enrollment IDStateProvider typePAC IDDetails
I20210628001904 CT Order and Referring Only - DentistPractitioner - Dentist 0547661688

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN122857GAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1621555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683590400000",
    "number": "1902471105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "650 PONCE DE LEON AVE STE. 300",
            "address_2": "1164",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303081804",
            "telephone_number": "860-559-4795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2730 PEACHTREE INDUSTRIAL BLVD STE 202",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300978628",
            "telephone_number": "678-385-9355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ONYIRIMBA",
        "first_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-05-21",
        "last_updated": "2023-05-09",
        "certification_date": "2023-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN122857",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Duluth, GA

Sources for this page

Verify at the official NPI Registry.