Active NPI
Sunday Adebare Bamigboye
- Dentist
- Winston Salem, NC
National Provider Identifier
1992680409
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 14315
- Practice address
- 1027 Hanes Mall Blvd
Winston Salem, NC 27103-1310 - Phone
- (743) 249-2908
- NPI assigned
- Aug 6, 2025
- Sex
- Unspecified or another gender identity
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 14315 | NC | Primary |
Addresses
Primary practice location
1027 Hanes Mall Blvd
Winston Salem, NC 27103-1310
Mailing address
103 Brightleaf Rd
Hillsborough, NC 27278-2456
Phone (915) 304-9467
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1754438400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1754438400000",
"number": "1992680409",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "103 BRIGHTLEAF RD",
"city": "HILLSBOROUGH",
"state": "NC",
"postal_code": "272782456",
"telephone_number": "915-304-9467",
"fax_number": "915-304-9467"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1027 HANES MALL BLVD",
"city": "WINSTON SALEM",
"state": "NC",
"postal_code": "271031310",
"telephone_number": "743-249-2908"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAMIGBOYE",
"first_name": "SUNDAY",
"middle_name": "ADEBARE",
"sole_proprietor": "NO",
"sex": "X",
"enumeration_date": "2025-08-06",
"last_updated": "2025-08-06",
"certification_date": "2025-08-06",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NC",
"license": "14315",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Winston Salem, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.