MEDICARE: EZIDOZI GROUP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist

General Provider Information

NPI Number	:	1053267419
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EZIDOZI GROUP

Provider Business Mailing Address
First Line	:	7820 SENECA RIDGE LN S
Second Line	:
City	:	HANOVER
State	:	MD
Zip	:	21076-2424
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3333 OLNEY SANDY SPRING RD STE 201
Second Line	:
City	:	OLNEY
State	:	MD
Zip	:	20832-1606
Country	:	US
Telephone Number	:	240-389-2433
Fax Number	:

Authorized Official
Title or Position	:	MEMBER
Name	:	DR. INNOCENT CHIDOZIE NWANYA
Credential	:	DDS
Telephone Number	:	240-389-2433

Provider Enumeration Date	:	03/09/2026
Last Update Date	:	03/09/2026

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Directions to “EZIDOZI GROUP ” Practice Location

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