Healthcare Provider Details

I. General information

NPI: 1568994622
Provider Name (Legal Business Name): DR. CHIDI EKE
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/29/2017
Last Update Date: 12/12/2025
Certification Date: 12/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7351 ASSATEAGUE DR STE 330
JESSUP MD
20794-3254
US

IV. Provider business mailing address

1001 N POINT BLVD STE 503
BALTIMORE MD
21224-3413
US

V. Phone/Fax

Practice location:
  • Phone: 240-305-1281
  • Fax: 410-824-1588
Mailing address:
  • Phone: 410-282-8900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number16362
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: