Provider Demographics
NPI:1689363228
Name:NWEZE, OGOCHUKWU SILVIA
Entity Type:Individual
Prefix:
First Name:OGOCHUKWU
Middle Name:SILVIA
Last Name:NWEZE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 S 16TH ST APT 811
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68102-1638
Mailing Address - Country:US
Mailing Address - Phone:713-382-1175
Mailing Address - Fax:
Practice Address - Street 1:605 NORTHWEST PKWY STE 130
Practice Address - Street 2:
Practice Address - City:AZLE
Practice Address - State:TX
Practice Address - Zip Code:76020-2946
Practice Address - Country:US
Practice Address - Phone:817-270-2429
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-01
Last Update Date:2023-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX39629122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist