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General NPI Number Information
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NPI Number | 1790603074
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Entity Type | Individual
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Provider Name | CHIEMEZUO JEAN OKONKWO DDS
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Gender | Female
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Dates
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Enumeration Date | 07/06/2026
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Last Update Date | 07/06/2026
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Provider Practice Location Address
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Address Line | 1001 STADIUM DR
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City | WAKE FOREST
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State | NC
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Zip | 27587-4655
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Country | US
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Telephone | 984-213-4412
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Fax |
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Provider Business Mailing Address
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Address Line | 654 GIMARI DR
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City | WAKE FOREST
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State | NC
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Zip | 27587-3390
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Country | US
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Telephone | 984-370-4397
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 14821
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License Number State | NC
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