Provider Demographics
NPI:1982806816
Name:OKABE, CHIKA (DMD)
Entity Type:Individual
Prefix:DR
First Name:CHIKA
Middle Name:
Last Name:OKABE
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2878 RIDGEMORE RD NW
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30318-1448
Mailing Address - Country:US
Mailing Address - Phone:404-351-4748
Mailing Address - Fax:
Practice Address - Street 1:2024 POWERS FERRY RD SE
Practice Address - Street 2:SUITE 190
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30339-5011
Practice Address - Country:US
Practice Address - Phone:770-953-6666
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN012057122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist