Provider Demographics
NPI:1083715734
Name:ADIBE, ELOCHUKWU (DMD)
Entity Type:Individual
Prefix:DR
First Name:ELOCHUKWU
Middle Name:
Last Name:ADIBE
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:124 SUMMER RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:LANSDALE
Mailing Address - State:PA
Mailing Address - Zip Code:19446-6710
Mailing Address - Country:US
Mailing Address - Phone:267-263-4899
Mailing Address - Fax:
Practice Address - Street 1:2 RESEARCH WAY STE 201
Practice Address - Street 2:
Practice Address - City:MONROE TOWNSHIP
Practice Address - State:NJ
Practice Address - Zip Code:08831-6820
Practice Address - Country:US
Practice Address - Phone:609-395-9100
Practice Address - Fax:609-395-9101
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2019-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0511691223G0001X
PADS0368671223P0700X
NJ22DI023149001223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics
No1223G0001XDental ProvidersDentistGeneral Practice