Provider Demographics
NPI:1700181880
Name:UKA, NDIDI (DDS)
Entity Type:Individual
Prefix:DR
First Name:NDIDI
Middle Name:
Last Name:UKA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:NDIDI
Other - Middle Name:
Other - Last Name:ONUGHA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3756 SANTA ROSALIA DR
Mailing Address - Street 2:#517
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90008-3606
Mailing Address - Country:US
Mailing Address - Phone:323-298-7992
Mailing Address - Fax:
Practice Address - Street 1:3756 SANTA ROSALIA DR
Practice Address - Street 2:SUITE 517
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90008-3606
Practice Address - Country:US
Practice Address - Phone:323-298-7992
Practice Address - Fax:323-298-7993
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-20
Last Update Date:2024-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA796011223S0112X
CA60123122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery