Provider Demographics
NPI:1295082303
Name:IKE, UGOCHI C (DDS)
Entity type:Individual
Prefix:DR
First Name:UGOCHI
Middle Name:C
Last Name:IKE
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 1:270 COBB PKWY S STE 180
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30060-6520
Mailing Address - Country:US
Mailing Address - Phone:770-425-6333
Mailing Address - Fax:
Practice Address - Street 1:270 COBB PKWY S STE 180
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30060-6520
Practice Address - Country:US
Practice Address - Phone:770-425-6333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-08
Last Update Date:2021-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN94871223G0001X
GADN016151122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice