Provider Demographics
NPI:1598996365
Name:ANANABA, NEJAY PAULINE (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:NEJAY
Middle Name:PAULINE
Last Name:ANANABA
Suffix:
Gender:F
Credentials:DDS, MS
Other - Prefix:
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Mailing Address - Street 1:629 SUNDROP DR
Mailing Address - Street 2:
Mailing Address - City:LITTLE ELM
Mailing Address - State:TX
Mailing Address - Zip Code:75068-4926
Mailing Address - Country:US
Mailing Address - Phone:985-306-2308
Mailing Address - Fax:
Practice Address - Street 1:790 N PRESTON RD STE 10
Practice Address - Street 2:
Practice Address - City:PROSPER
Practice Address - State:TX
Practice Address - Zip Code:75078-9840
Practice Address - Country:US
Practice Address - Phone:972-984-7345
Practice Address - Fax:972-984-5227
Is Sole Proprietor?:No
Enumeration Date:2009-07-28
Last Update Date:2020-01-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX338561223P0221X
MI29010200431223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
No1223G0001XDental ProvidersDentistGeneral Practice