Emmanuel Nnaji Okonkwo, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

29932 Issued in CA

Practice address

1704 W Manchester Ave
Suite 208
Los Angeles, CA 90047-3034

Phone

(323) 971-5025

Fax

(323) 750-8399

NPI assigned

Apr 18, 2007

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1176854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1629295290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3777",
            "city": "PALOS VERDES PENINSULA",
            "state": "CA",
            "postal_code": "902749528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1704 W MANCHESTER AVE",
            "address_2": "SUITE 208",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900473034",
            "telephone_number": "323-971-5025",
            "fax_number": "323-750-8399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OKONKWO",
        "first_name": "EMMANUEL",
        "middle_name": "NNAJI",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "29932",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTI-CAL PROVIDER NO.",
            "identifier": "G9323001",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kingsley Okon, BA
• Anna Okonek, PH.D.
• Godwin Chukwuemeka Okonji
• Charles I Okonkwo, M.D.
• Chukwuma Okonkwo
• John Okechukwu Okonkwo
• Njideka Afulenu Okonkwo I
• Nnaemeka Michael Okonkwo
• Samuel Okonkwo
• Kechinyere Adaku Okorie, PT, DPT

• Dentist in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.