Provider Demographics
NPI:1629418371
Name:OKEKE, YOUNG (DDS, MSD)
Entity Type:Individual
Prefix:DR
First Name:YOUNG
Middle Name:
Last Name:OKEKE
Suffix:
Gender:M
Credentials:DDS, MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:999 PEACHTREE ST NE STE 705
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30309-3964
Mailing Address - Country:US
Mailing Address - Phone:404-885-1441
Mailing Address - Fax:404-885-1410
Practice Address - Street 1:999 PEACHTREE ST NE STE 705
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30309-3964
Practice Address - Country:US
Practice Address - Phone:404-885-1441
Practice Address - Fax:404-885-1410
Is Sole Proprietor?:No
Enumeration Date:2013-06-26
Last Update Date:2022-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN0153821223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics