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1477049617 NPI number — ONAEDO ACHEBE

NPI Number: 1477049617
Health Care Provider/Practitioner: ONAEDO ACHEBE

Information about “1477049617” NPI (ONAEDO ACHEBE) exists in 1477049617 in HTML format HTML  |  1477049617 in plain Text format TXT  |  1477049617 in PDF (Portable Document Format) PDF  |  1477049617 in an XML format XML  formats.

NPI Number : 1477049617 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1477049617",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "ACHEBE",
    "FirstName": "ONAEDO",
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "350 N CLARK ST FL 6",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "CHICAGO",
    "MailingAddressStateName": "IL",
    "MailingAddressPostalCode": "60654-4712",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "312-274-4524",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "1553 ALABAMA AVE SE",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "WASHINGTON",
    "PracticeLocationAddressStateName": "DC",
    "PracticeLocationAddressPostalCode": "20032",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "312-274-4524",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "07/10/2018",
    "LastUpdateDate": "02/20/2024",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "122300000X",
          "TaxonomyName": "Dentist",
          "LicenseNumber": "DEN1001906",
          "LicenseNumberStateCode": "DC",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "390200000X",
          "TaxonomyName": "Student in an Organized Health Care Education/Training Program",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "122300000X",
          "TaxonomyName": "Dentist",
          "LicenseNumber": "2023028005",
          "LicenseNumberStateCode": "MO",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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