MEDICARE: CHIKONYA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	28871	TX

General Provider Information

NPI Number	:	1750816658
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHIKONYA

Provider Business Mailing Address
First Line	:	4611 STEEL ST
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75219-2421
Country	:	US
Telephone Number	:	484-802-4619
Fax Number	:

Provider Business Practice Location Address
First Line	:	4611 STEEL ST
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75219-2421
Country	:	US
Telephone Number	:	484-802-4619
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. DANIEL O NNADIUGWU
Credential	:	DDS
Telephone Number	:	484-802-4619

Provider Enumeration Date	:	04/28/2017
Last Update Date	:	04/28/2017

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Directions to “CHIKONYA ” Practice Location

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