Individual provider Active NPI

Anne-Marie Ushunu Umoren

  • Dentist
  • Boynton Beach, FL
National Provider Identifier
1942616453
Registry record updated Nov 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN20750 Issued in FL
Practice address
2280 N Congress Ave
Boynton Beach, FL 33426
Phone
(561) 732-2400
NPI assigned
Jul 3, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 17, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 20750 FL
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X DN20750 FL Primary

Addresses

Primary practice location

2280 N Congress Ave
Boynton Beach, FL 33426

Mailing address

15068 S Jog Rd
Delray Beach, FL 33446-1218
Phone (561) 403-5901

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

LicenseStateTypeSpecialty
20750FLMDDentist
DN20750FLMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Umoren Dental, P.a. Single Specialty Current Accepting new patients
Modern Dental Smiles PA Past Accepting new patients

Locations

15068 S Jog Rd
Delray Beach, FL 33446
Phone (561) 403-5901

Networks

  • Freedom Health HMO Network

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": "1404345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668643200000",
    "number": "1942616453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15068 S JOG RD",
            "city": "DELRAY BEACH",
            "state": "FL",
            "postal_code": "334461218",
            "telephone_number": "561-403-5901",
            "fax_number": "561-403-5972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2280 N CONGRESS AVE",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "33426",
            "telephone_number": "561-732-2400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UMOREN",
        "first_name": "ANNE-MARIE",
        "middle_name": "USHUNU",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-07-03",
        "last_updated": "2022-11-17",
        "certification_date": "2022-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "20750",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN20750",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boynton Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 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.