Provider Demographics
NPI:1518350248
Name:AKPOBOME, OGHENEJIRO (DDS)
Entity Type:Individual
Prefix:
First Name:OGHENEJIRO
Middle Name:
Last Name:AKPOBOME
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 1:4828 OLD SPANISH TRL UNIT A
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77021-1721
Mailing Address - Country:US
Mailing Address - Phone:832-305-5476
Mailing Address - Fax:
Practice Address - Street 1:4828 OLD SPANISH TRL UNIT A
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77021-1721
Practice Address - Country:US
Practice Address - Phone:832-305-5476
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-04
Last Update Date:2023-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMTD-00-72390200000X
TX334061223S0112X, 122300000X
NMDD4478122300000X
NM390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No122300000XDental ProvidersDentist