Provider Demographics
NPI:1598761462
Name:ANYADIKE, ANTHONY C (DDS)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:C
Last Name:ANYADIKE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:DR
Other - First Name:TONY
Other - Middle Name:C
Other - Last Name:ANYADIKE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
Mailing Address - Street 1:30 GREENWAY ST NW
Mailing Address - Street 2:SUITE 4
Mailing Address - City:GLEN BURNIE
Mailing Address - State:MD
Mailing Address - Zip Code:21061-3557
Mailing Address - Country:US
Mailing Address - Phone:410-760-8888
Mailing Address - Fax:410-760-8898
Practice Address - Street 1:30 GREENWAY ST NW
Practice Address - Street 2:SUITE 4
Practice Address - City:GLEN BURNIE
Practice Address - State:MD
Practice Address - Zip Code:21061-3557
Practice Address - Country:US
Practice Address - Phone:410-760-8888
Practice Address - Fax:410-760-8898
Is Sole Proprietor?:No
Enumeration Date:2005-06-24
Last Update Date:2007-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD70581223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics