Healthcare Provider Details

I. General information

NPI: 1376275545
Provider Name (Legal Business Name): TERRY CHIKE AKPUA DDS, MBA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/27/2022
Last Update Date: 05/05/2025
Certification Date: 05/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7371 ASSATEAGUE DR STE 300
JESSUP MD
20794-3201
US

IV. Provider business mailing address

13108 13TH ST
BOWIE MD
20715-4500
US

V. Phone/Fax

Practice location:
  • Phone: 301-760-2194
  • Fax: 301-760-2304
Mailing address:
  • Phone: 301-803-8423
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number18344
License Number StateMD
# 3
Primary TaxonomyN
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number0401419342
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: