Provider Demographics
NPI:1942469291
Name:AMOAH, EMMANUEL KWESI (DDS)
Entity Type:Individual
Prefix:DR
First Name:EMMANUEL
Middle Name:KWESI
Last Name:AMOAH
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3709 KECOUGHTAN ROAD
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:VA
Mailing Address - Zip Code:23669-4405
Mailing Address - Country:US
Mailing Address - Phone:757-722-8507
Mailing Address - Fax:757-690-8765
Practice Address - Street 1:3709 KECOUGHTAN ROAD
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:VA
Practice Address - Zip Code:23669-4405
Practice Address - Country:US
Practice Address - Phone:757-484-1202
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-03
Last Update Date:2023-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014121001223G0001X
CT390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes1223G0001XDental ProvidersDentistGeneral Practice