Provider Demographics
NPI:1750100079
Name:OKANY, KENECHI (DDS)
Entity type:Individual
Prefix:
First Name:KENECHI
Middle Name:
Last Name:OKANY
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 1:2770 HOOPER AVE UNIT 4
Mailing Address - Street 2:
Mailing Address - City:BRICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08723-4160
Mailing Address - Country:US
Mailing Address - Phone:732-965-3682
Mailing Address - Fax:
Practice Address - Street 1:2770 HOOPER AVE UNIT 4
Practice Address - Street 2:
Practice Address - City:BRICK
Practice Address - State:NJ
Practice Address - Zip Code:08723-4160
Practice Address - Country:US
Practice Address - Phone:609-489-0030
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-03
Last Update Date:2024-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI030551001223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics