Healthcare Provider Details

I. General information

NPI: 1417334244
Provider Name (Legal Business Name): EFEMA PAMELA NWAJEI DDS DENTAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/30/2015
Last Update Date: 01/10/2024
Certification Date: 01/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6767 N FRESNO ST STE 200
FRESNO CA
93710-3740
US

IV. Provider business mailing address

6767 N FRESNO ST STE 200
FRESNO CA
93710-3740
US

V. Phone/Fax

Practice location:
  • Phone: 559-447-3020
  • Fax: 559-447-3025
Mailing address:
  • Phone: 559-447-3020
  • Fax: 559-447-3025

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number60838
License Number StateCA

VIII. Authorized Official

Name: DR. EFEMA NWAJEI
Title or Position: OWNER/PRESIDENT
Credential: DDS
Phone: 908-391-6809