Healthcare Provider Details

I. General information

NPI: 1992699375
Provider Name (Legal Business Name): ADAOBI JENNIFER OBUNADIKE DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/09/2025
Last Update Date: 06/09/2025
Certification Date: 05/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

421 PHOENIX DR
CHAMBERSBURG PA
17201-4534
US

IV. Provider business mailing address

10 KRUEGER CT
NEWARK NJ
07103-3464
US

V. Phone/Fax

Practice location:
  • Phone: 717-264-9275
  • Fax:
Mailing address:
  • Phone: 716-495-4418
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDS045155
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: