Provider Demographics
NPI:1114338738
Name:AKPAKA, WISDOM D (DDS)
Entity Type:Individual
Prefix:
First Name:WISDOM
Middle Name:D
Last Name:AKPAKA
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4078 ROTTERDAM PASS
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:GA
Mailing Address - Zip Code:30228-6077
Mailing Address - Country:US
Mailing Address - Phone:678-650-2198
Mailing Address - Fax:
Practice Address - Street 1:930 BOARDMAN POLAND RD
Practice Address - Street 2:
Practice Address - City:BOARDMAN
Practice Address - State:OH
Practice Address - Zip Code:44512-5117
Practice Address - Country:US
Practice Address - Phone:330-629-8884
Practice Address - Fax:216-584-1070
Is Sole Proprietor?:No
Enumeration Date:2014-05-16
Last Update Date:2015-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30.024305122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist