GIDEON IKECHUKW OCHIABUTO (NPI# 1902072366) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902072366 |
| Entity Type | Individual |
| Full Name | GIDEON IKECHUKW OCHIABUTO |
| Practice Address |
137 State Route 104 Oswego NY 13126-2937 |
| Mailing Address |
Po Box 3189 Syracuse NY 13220-3189 |
| Practice Telephone | 3153425700 |
| Mailing Telephone | 3154546000 |
| Enumeration Date | 2008-05-06 |
| Last Update Date | 2008-05-06 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
053709 | NY | Dental Providers |
| Street Address |
137 STATE ROUTE 104 |
| City | OSWEGO |
| State | NY |
| Zip Code | 13126-2937 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619197597 | Murshed Rahman | Dentist | 137 State Route 104, Oswego, NY 13126-2937 | 2007-04-26 |
| 1467880617 | David James Maricondo | Dentist | 137 State Route 104, Oswego, NY 13126-2937 | 2013-10-25 |
| 1285919506 | Danielle E Maciorowski | Pharmacist | 137 State Route 104, Oswego, NY 13126-2937 | 2011-10-18 |
| 1477718807 | John L Cloonan | Pharmacist | 137 State Route 104, Oswego, NY 13126-2937 | 2008-07-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992303572 | Elise Fitzsimmons | Specialist/Technologist | 9 Laker Hall, Oswego, NY 13126 | 2020-10-15 |
| 1023651742 | Jessica Lynn Metzger | Physician Assistant | 300 Ny-104 Suite 1, Oswego, NY 13126 | 2019-10-25 |
| 1245887009 | Maureen Adams | Technician | 30 Stone Ridge Drive, Oswego, NY 13126 | 2019-08-26 |
| 1285128314 | Justin Raymond Beebe | Nurse Practitioner | 300 State Route 104 Ste 2, Oswego, NY 13126 | 2018-06-21 |
| 1801311220 | Lynne M Wallace | Registered Nurse | 29 Birch Lane 17b, Oswego, NY 13126 | 2017-08-07 |
| 1497203962 | Lindsay Cheslock | Local Education Agency (LEA) | 529 County Route 25, Oswego, NY 13126 | 2016-09-14 |
| 1942757919 | Aimee Devinny | Registered Nurse | 21 Twin Orchard Drive, Oswego, NY 13126 | 2016-09-07 |
| 1083160295 | Cameron Delmotte | Specialist | 159 West Frist Street, Oswego, NY 13126 | 2016-08-28 |
| 1508319187 | Samantha Thayer | Occupational Therapist | 159 West First Oswego St, Oswego, NY 13126 | 2016-07-29 |
| 1104279595 | Vikram Jala | Internal Medicine | 105 County Route 45a Ste 400, Oswego, NY 13126 | 2016-07-20 |
| Find all providers in zip 13126 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669092177 | Dental Professionals of Illinois, P.C. | Dentist | 3419 Orchard Rd, Oswego, IL 60543-5005 | 2020-04-24 |
| 1174181770 | Oswego Dental Group, LLC | Dentist | 4771 Route 71, Oswego, IL 60543-7415 | 2019-05-30 |
| 1548723596 | Arena Dental Associates, PC | Dentist | 63 W 2nd St, Oswego, NY 13126-1515 | 2019-04-08 |
| 1780113233 | Tam Huu Ngo | Dentist | 2484 Us Highway 30 Ste B101, Oswego, IL 60543-8974 | 2017-06-08 |
| 1386015808 | Brittany A Shubert | Dentist | 1016 Douglas Rd # A, Oswego, IL 60543-9865 | 2015-10-09 |
| 1346651577 | Dental Professionals of Illinois, P.C. | Dentist | 1490 Douglas Rd, Oswego, IL 60543-5106 | 2014-05-09 |
| 1275847204 | Oswego East Dental Associates | Dentist | 1768 Douglas Rd, Oswego, IL 60543 | 2010-08-02 |
| 1548591894 | Oswego Dental | Dentist | 2484 Route 30, Oswego, IL 60543 | 2010-01-27 |
| 1437302734 | Valley Dental Care LLP | Dentist | 3415 Orchard Rd, Oswego, IL 60543 | 2008-10-30 |
| 1194976209 | Fox River Dental | Dentist | 2968 Route 34, Oswego, IL 60543 | 2008-10-07 |
| Find all providers in OSWEGO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.