Provider Demographics
NPI:1710687074
Name:EKOH, DANIEL EDOBOR (DMD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:EDOBOR
Last Name:EKOH
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 1:1002 OAKLEY AVE APT C
Mailing Address - Street 2:
Mailing Address - City:LYNCHBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24501-3758
Mailing Address - Country:US
Mailing Address - Phone:434-258-4941
Mailing Address - Fax:
Practice Address - Street 1:4011 WARDS RD
Practice Address - Street 2:
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24502-2943
Practice Address - Country:US
Practice Address - Phone:434-329-3197
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-06
Last Update Date:2023-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014186281223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice