Provider Demographics
NPI:1164061453
Name:OKINEDO, EMAMEFE EWOMAZINO (DMD)
Entity Type:Individual
Prefix:DR
First Name:EMAMEFE
Middle Name:EWOMAZINO
Last Name:OKINEDO
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:DR
Other - First Name:EMAMEFE
Other - Middle Name:EWOMAZINO
Other - Last Name:OVEH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BDS
Mailing Address - Street 1:28818 INNES PARK PL
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77494-6947
Mailing Address - Country:US
Mailing Address - Phone:662-380-0331
Mailing Address - Fax:
Practice Address - Street 1:28818 INNES PARK PL
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77494-6947
Practice Address - Country:US
Practice Address - Phone:662-380-0331
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-03
Last Update Date:2020-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX358581223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice