Provider Demographics
NPI:1336985860
Name:ONYEJIAKA, KELECHI (DMD)
Entity type:Individual
Prefix:DR
First Name:KELECHI
Middle Name:
Last Name:ONYEJIAKA
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1477 MAIN ST UNIT 1806
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64105-3619
Mailing Address - Country:US
Mailing Address - Phone:713-398-6353
Mailing Address - Fax:
Practice Address - Street 1:3608 FARAON ST
Practice Address - Street 2:
Practice Address - City:SAINT JOSEPH
Practice Address - State:MO
Practice Address - Zip Code:64506-3044
Practice Address - Country:US
Practice Address - Phone:816-364-6444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-03
Last Update Date:2024-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20240250461223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice