Provider Demographics
NPI:1750816658
Name:CHIKONYA
Entity type:Organization
Organization Name:CHIKONYA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:O
Authorized Official - Last Name:NNADIUGWU
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:484-802-4619
Mailing Address - Street 1:4611 STEEL ST
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75219-2421
Mailing Address - Country:US
Mailing Address - Phone:484-802-4619
Mailing Address - Fax:
Practice Address - Street 1:4611 STEEL ST
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75219-2421
Practice Address - Country:US
Practice Address - Phone:484-802-4619
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-28
Last Update Date:2017-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX288711223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty