NPIMap

Organization Active NPI

Jamel D. Odeh DDS PA

  • General Practice Dentistry
  • Greensboro, NC
National Provider Identifier
1982637807
Registry record updated Mar 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
6163 Issued in NC
Legal business name
JAMEL D. ODEH DDS PA
Practice address
4119 Walker Ave
Greensboro, NC 27407-1315
Phone
(336) 294-2322
Fax
(336) 294-2323
NPI assigned
Jul 7, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2017

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

Authorized official

Name
Dr. Jamel D Odeh, DDSNPI 1770653065
Title
Owner/Dentist
Phone
(336) 294-2322

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 6163 NC Primary

Addresses

Primary practice location

4119 Walker Ave
Greensboro, NC 27407-1315

Mailing address

4119 Walker Ave
Greensboro, NC 27407-1315
Phone (336) 294-2322

Other identifiers 1

IdentifierTypeStateIssuer
5901367MedicaidNC

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1489363200000",
    "number": "1982637807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4119 WALKER AVE",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274071315",
            "telephone_number": "336-294-2322",
            "fax_number": "336-294-2323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4119 WALKER AVE",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274071315",
            "telephone_number": "336-294-2322",
            "fax_number": "336-294-2323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAMEL D. ODEH DDS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-07",
        "last_updated": "2017-03-13",
        "status": "A",
        "authorized_official_last_name": "ODEH",
        "authorized_official_first_name": "JAMEL",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "336-294-2322",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "6163",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5901367",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greensboro, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2017; 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.