Chidiogo Obi
Individual provider Active NPI Dentist · Roeland Park, KS
NPI 1417696147 · NPPES record last updated Jun 1, 2022
Key facts
- NPI
- 1417696147
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 61859 (KS)
- Practice address
- 5201 Roe Blvd
Roeland Park, KS 66205-2390 - Phone
- (913) 828-0060
- NPI assigned
- Jun 1, 2022
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 61859 | KS | MD | Dentist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist |
122300000X | 61859 | KS | Yes |
Addresses
Primary practice location
5201 Roe Blvd
Roeland Park, KS 66205-2390
Mailing address
4050 Oak St
Kansas City, MO 64111-1613
Other providers in Roeland Park, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 1, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.