Provider Demographics
NPI:1023855442
Name:AUDU, OCHUWA (DDS)
Entity type:Individual
Prefix:
First Name:OCHUWA
Middle Name:
Last Name:AUDU
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 1:42 ALGONQUIN RD
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:VA
Mailing Address - Zip Code:23661-3454
Mailing Address - Country:US
Mailing Address - Phone:949-228-3877
Mailing Address - Fax:
Practice Address - Street 1:2165 CUNNINGHAM DR
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:VA
Practice Address - Zip Code:23666-2569
Practice Address - Country:US
Practice Address - Phone:757-755-8829
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-12
Last Update Date:2025-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014193031223G0001X
390200000X
GADN123572122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program