Provider Demographics
NPI:1811441389
Name:NWANKWO, OBINNA EMEKA (DDS)
Entity type:Individual
Prefix:
First Name:OBINNA
Middle Name:EMEKA
Last Name:NWANKWO
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2906 W ROYAL LN
Mailing Address - Street 2:APT 3029
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75063-6200
Mailing Address - Country:US
Mailing Address - Phone:214-926-2292
Mailing Address - Fax:
Practice Address - Street 1:2906 W ROYAL LN
Practice Address - Street 2:APT 3029
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75063-6200
Practice Address - Country:US
Practice Address - Phone:214-926-2292
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-12
Last Update Date:2016-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX32228122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist