Provider Demographics
NPI:1942017058
Name:CHILDREN'S DENTISTRY OF ARLINGTON
Entity type:Organization
Organization Name:CHILDREN'S DENTISTRY OF ARLINGTON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:IFEANYI
Authorized Official - Middle Name:ALEX
Authorized Official - Last Name:OKOYE
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:281-857-5514
Mailing Address - Street 1:2301 COLUMBIA PIKE APT 123
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22204-4453
Mailing Address - Country:US
Mailing Address - Phone:703-634-9450
Mailing Address - Fax:703-962-3339
Practice Address - Street 1:2301 COLUMBIA PIKE APT 123
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22204-4453
Practice Address - Country:US
Practice Address - Phone:703-634-9450
Practice Address - Fax:703-962-3339
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-12
Last Update Date:2024-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Multi-Specialty
No1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Multi-Specialty