Provider Demographics
NPI:1144244773
Name:ACHIKEH, KINGSLEY UCHE (DDS)
Entity Type:Individual
Prefix:DR
First Name:KINGSLEY
Middle Name:UCHE
Last Name:ACHIKEH
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 1:8780 GEORGIA AVE
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910-3645
Mailing Address - Country:US
Mailing Address - Phone:301-585-1515
Mailing Address - Fax:301-585-5206
Practice Address - Street 1:8780 GEORGIA AVE
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-3645
Practice Address - Country:US
Practice Address - Phone:301-585-1515
Practice Address - Fax:301-585-5206
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2017-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD11956122300000X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD298803800Medicaid
MD11956OtherLICENCE
DCDEN5719OtherLICENCE