Healthcare Provider Details

I. General information

NPI: 1982806816
Provider Name (Legal Business Name): CHIKA OKABE D.M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/04/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2024 POWERS FERRY RD SE SUITE 190
ATLANTA GA
30339-5011
US

IV. Provider business mailing address

2878 RIDGEMORE RD NW
ATLANTA GA
30318-1448
US

V. Phone/Fax

Practice location:
  • Phone: 770-953-6666
  • Fax:
Mailing address:
  • Phone: 404-351-4748
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDN012057
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: