Ehizogie Paul Adeghe, DDS,MPH – Dentist

Key facts

NPI: 1992522692
Entity type: Individual (NPI type 1)
Primary specialty: Dentist 122300000X
License: 0160134303 (VT)
Practice address: 7 Farrell St
South Burlington, VT 05403-6113
Phone: (813) 710-4378
NPI assigned: Sep 24, 2024
Sex: Male
Sole proprietor: No

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): No

State licenses

License	State	Type	Specialty
0160134303	VT	MD	Dentist

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Dentist	122300000X	0160134303	VT	Yes

Addresses

Primary practice location

7 Farrell St
South Burlington, VT 05403-6113

Mailing address

2231 Disston St
Philadelphia, PA 19149-1917
Phone (434) 258-7195

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Oct 22, 2024.

{
    "created_epoch": "1727136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729555200000",
    "number": "1992522692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2231 DISSTON ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191491917",
            "telephone_number": "434-258-7195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 FARRELL ST",
            "city": "SOUTH BURLINGTON",
            "state": "VT",
            "postal_code": "054036113",
            "telephone_number": "813-710-4378"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADEGHE",
        "first_name": "EHIZOGIE",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "DDS,MPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-09-24",
        "last_updated": "2024-10-22",
        "certification_date": "2024-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VT",
            "license": "0160134303",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Burlington, VT

All providers in South Burlington, VT · Dentist in Vermont

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 22, 2024. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.