Provider Demographics
NPI:1104053545
Name:CHILO OBIANWU DMD. ALL SMILES DENTAL CARE P.C
Entity type:Organization
Organization Name:CHILO OBIANWU DMD. ALL SMILES DENTAL CARE P.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DMD
Authorized Official - Prefix:
Authorized Official - First Name:CHILO
Authorized Official - Middle Name:N
Authorized Official - Last Name:OBIANWU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-702-4080
Mailing Address - Street 1:12803 OLD FORT RD STE 203
Mailing Address - Street 2:
Mailing Address - City:FORT WASHINGTON
Mailing Address - State:MD
Mailing Address - Zip Code:20744-2801
Mailing Address - Country:US
Mailing Address - Phone:240-253-1965
Mailing Address - Fax:240-253-1966
Practice Address - Street 1:12803 OLD FORT RD STE 203
Practice Address - Street 2:
Practice Address - City:FORT WASHINGTON
Practice Address - State:MD
Practice Address - Zip Code:20744-2801
Practice Address - Country:US
Practice Address - Phone:240-253-1965
Practice Address - Fax:240-253-1966
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CHILO OBIANWU DMD. ALL SMILES DENTAL CARE P.C
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-06-12
Last Update Date:2025-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QD0000X
MD13826122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
No261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDentalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD010761101Medicaid