Healthcare Provider Details

I. General information

NPI: 1275453029
Provider Name (Legal Business Name): EBERECHUKWU EBUNLOMO NWADE DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2026
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6196 OXON HILL RD STE 390
OXON HILL MD
20745-3122
US

IV. Provider business mailing address

10032 DORSEY LN
LANHAM MD
20706-2565
US

V. Phone/Fax

Practice location:
  • Phone: 301-839-0494
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number18890
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: