Provider Demographics
NPI:1710115894
Name:IDAKOJI, BILKISU INIKPI (DDS)
Entity Type:Individual
Prefix:DR
First Name:BILKISU
Middle Name:INIKPI
Last Name:IDAKOJI
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 1:7758 W TIDWELL RD
Mailing Address - Street 2:STE 126
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77040-5741
Mailing Address - Country:US
Mailing Address - Phone:510-676-4783
Mailing Address - Fax:
Practice Address - Street 1:7758 W TIDWELL RD
Practice Address - Street 2:STE 126
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77040-5741
Practice Address - Country:US
Practice Address - Phone:510-676-4783
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-26
Last Update Date:2012-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0538761223P0221X
TX249891223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX208343801Medicaid