Provider Demographics
NPI:1629716253
Name:OKEKE, CHIAMAKA (DDS)
Entity Type:Individual
Prefix:
First Name:CHIAMAKA
Middle Name:
Last Name:OKEKE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1834 BROADWAY ST APT 1
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70118-5369
Mailing Address - Country:US
Mailing Address - Phone:504-344-8004
Mailing Address - Fax:
Practice Address - Street 1:2840 MANHATTAN BLVD
Practice Address - Street 2:
Practice Address - City:HARVEY
Practice Address - State:LA
Practice Address - Zip Code:70058-2988
Practice Address - Country:US
Practice Address - Phone:504-324-3353
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-24
Last Update Date:2022-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA73291223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice