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General NPI Number Information
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NPI Number | 1750816658
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Entity Type | Organization
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Legal Business Name | CHIKONYA
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Dates
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Enumeration Date | 04/28/2017
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Last Update Date | 04/28/2017
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Provider Practice Location Address
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Address Line | 4611 STEEL ST
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City | DALLAS
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State | TX
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Zip | 75219-2421
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Country | US
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Telephone | 484-802-4619
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Fax |
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Provider Business Mailing Address
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Address Line | 4611 STEEL ST
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City | DALLAS
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State | TX
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Zip | 75219-2421
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Country | US
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Telephone | 484-802-4619
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. DANIEL O NNADIUGWU
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Credential | DDS
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Telephone | 484-802-4619
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 28871
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License Number State | TX
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