NPI age
19 years
Enumerated 2006-11-22
● Active
Type 1 · Individual
DR. Ikechukwu P. Ebo, D.D.S., P.A.
Ebo is 1 of 46 dentist providers in Lawrenceville and 1 of 2660 in Georgia.
Primary specialty
Dentist
Plus 1 subspecialty
Licensed in
GA, NC
2 states
Status
Active
No deactivations on record
Last NPPES update
2011-07-01
Source: monthly bulk 2026-05
Sole proprietor
Yes
Solo practice on file
How this provider compares
Across 2660 active dentist providers in Georgia.
NPI age
19 years
↑ 5 yr above median (14 yr)
State licenses
2 states
Top 90% — 9% of peers are multi-state
Subspecialties
1
In the 16% of peers with subspecialties
NPI lifetime · 2006 → 2026
2006-11Enumerated in NPPES
2006
2026
Where they practice
Practice location
650 Gwinnett Dr
Lawrenceville, GA 300467439
Mailing address
650 Gwinnett Dr.
Lawrenceville, GA 30045
Specialties
-
Dentist PrimaryA dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two...
-
DentistA 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.
Identifiers
| Type | Value | Notes |
|---|---|---|
| 05 (NC) | 89902F3 | |
| 05 (NC) | 5901375 |
Multi-state credentialing: Licensed in 2 states. Useful context for credentialers building cross-state provider networks.
Practice context
Solo or small practice. No other active providers share this practice address in NPPES. This provider is listed as a sole proprietor.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Check the state license is currently active.State licensing boards publish current status; NPPES does not.
- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.