Provider Demographics
NPI:1841796489
Name:IODDS, INC.
Entity Type:Organization
Organization Name:IODDS, INC.
Other - Org Name:O FAMILY DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:IRABOR
Authorized Official - Middle Name:I
Authorized Official - Last Name:OKOGBO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:832-674-4932
Mailing Address - Street 1:8190 BARKER CYPRESS RD STE 200
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77433-2279
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8190 BARKER CYPRESS RD STE 200
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77433-2279
Practice Address - Country:US
Practice Address - Phone:832-967-7332
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-03
Last Update Date:2019-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX27752261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental