Provider Demographics
NPI:1023725868
Name:SPARRROW DENTISTRY
Entity type:Organization
Organization Name:SPARRROW DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:IKECHUKWU
Authorized Official - Middle Name:
Authorized Official - Last Name:IHENATU
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:919-593-3791
Mailing Address - Street 1:1 WADES LNDG
Mailing Address - Street 2:
Mailing Address - City:NEW MILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06776-2666
Mailing Address - Country:US
Mailing Address - Phone:919-593-3791
Mailing Address - Fax:
Practice Address - Street 1:767 WOLCOTT ST STE 3
Practice Address - Street 2:
Practice Address - City:WATERBURY
Practice Address - State:CT
Practice Address - Zip Code:06705-1324
Practice Address - Country:US
Practice Address - Phone:919-593-3791
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-01
Last Update Date:2022-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental