Provider Demographics
NPI:1114494689
Name:OKEMWA DENTAL ASSOCIATES PLLC
Entity Type:Organization
Organization Name:OKEMWA DENTAL ASSOCIATES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ORTHODONTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JUANITA
Authorized Official - Middle Name:
Authorized Official - Last Name:OKEMWA
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:626-241-7325
Mailing Address - Street 1:2909 1ST RD N
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22201-1011
Mailing Address - Country:US
Mailing Address - Phone:626-241-7325
Mailing Address - Fax:
Practice Address - Street 1:818 18TH ST NW STE 747
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20006-3513
Practice Address - Country:US
Practice Address - Phone:202-347-2609
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-01
Last Update Date:2018-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty