Provider Demographics
NPI:1497292312
Name:ANYANWU, BRIAN CHINEDU (DDS)
Entity Type:Individual
Prefix:MR
First Name:BRIAN
Middle Name:CHINEDU
Last Name:ANYANWU
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 1:13503 VERBENA LN
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77083-1805
Mailing Address - Country:US
Mailing Address - Phone:832-264-6170
Mailing Address - Fax:
Practice Address - Street 1:2411 MIAMISBURG CENTERVILLE RD
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45459-3723
Practice Address - Country:US
Practice Address - Phone:937-436-5600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-30
Last Update Date:2023-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX32653122300000X
OH30.027251122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist