Individual provider Active NPI

Kwame Otuo-Achampong, DDS

  • General Practice Dentistry
  • Montgomery, AL
National Provider Identifier
1902474786
Registry record updated Dec 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D-0007128-C1 Issued in AL
Practice address
3439 B McGehee Rd Ste 22
Montgomery, AL 36111-3392
Phone
(334) 284-0228
NPI assigned
Jun 16, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 12, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X D-0007128-C1 AL
Student in an Organized Health Care Education/Training Program 390200000X NY
General Practice Dentistry 1223G0001X D-0007128-C1 AL Primary

Addresses

Primary practice location

3439 B McGehee Rd Ste 22
Montgomery, AL 36111-3392

Mailing address

3322 W End Ave Ste 400
Nashville, TN 37203-6805
Phone (629) 999-5014

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)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Advantage Dental Oral Health and Vision Center of Alabama, P.C. CurrentSince Dec 18, 2022 Accepting new patients
Advantage Dental Oral Health and Vision Center of Alabama, P.C. CurrentSince Dec 18, 2022 Accepting new patients

Locations

3439 McGehee Rd
Ste 22
Montgomery, AL 36111
Phone (334) 284-0228

3322 West End Ave
Ste 400
Nashville, TN 37203
Phone (629) 999-5014

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1623801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670803200000",
    "number": "1902474786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3322 W END AVE STE 400",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372036805",
            "telephone_number": "629-999-5014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3439 B MCGEHEE RD STE 22",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361113392",
            "telephone_number": "334-284-0228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OTUO-ACHAMPONG",
        "first_name": "KWAME",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-06-16",
        "last_updated": "2022-12-12",
        "certification_date": "2022-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AL",
            "license": "D-0007128-C1",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NY",
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AL",
            "license": "D-0007128-C1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montgomery, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2022; 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.