Provider Demographics
NPI:1801206982
Name:WINIFRED OGE DIKE, DDS PA
Entity Type:Organization
Organization Name:WINIFRED OGE DIKE, DDS PA
Other - Org Name:ASHLEY FAMILY DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:WINIFRED
Authorized Official - Middle Name:OGE
Authorized Official - Last Name:DIKE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:713-777-3368
Mailing Address - Street 1:8614 S. BRAESWOOD BLVD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77031
Mailing Address - Country:US
Mailing Address - Phone:713-777-3368
Mailing Address - Fax:713-777-3370
Practice Address - Street 1:8614 S BRAESWOOD BLVD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77031-1301
Practice Address - Country:US
Practice Address - Phone:713-777-3368
Practice Address - Fax:713-777-3370
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-29
Last Update Date:2014-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX21637122300000X
TX1417294919122300000X
TX1346561594122300000X
TX1831147909122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty