Provider Demographics
NPI:1629285002
Name:ORJIEKWE, OGONNA OGE (DMD)
Entity Type:Individual
Prefix:DR
First Name:OGONNA
Middle Name:OGE
Last Name:ORJIEKWE
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1091 ROSEBERRY CT
Mailing Address - Street 2:
Mailing Address - City:MORGANVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07751-1783
Mailing Address - Country:US
Mailing Address - Phone:732-970-3924
Mailing Address - Fax:
Practice Address - Street 1:37 HIGHWAY 35
Practice Address - Street 2:
Practice Address - City:EATONTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07724
Practice Address - Country:US
Practice Address - Phone:732-544-9101
Practice Address - Fax:732-544-0929
Is Sole Proprietor?:No
Enumeration Date:2007-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI022466001223G0001X
NY051597-11223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice