Provider Demographics
NPI:1386358315
Name:STELLA O NNADI DMD PA
Entity type:Organization
Organization Name:STELLA O NNADI DMD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STELLA
Authorized Official - Middle Name:O
Authorized Official - Last Name:NNADI
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:704-688-7588
Mailing Address - Street 1:10230 BERKELEY PLACE DR STE 200
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28262-1203
Mailing Address - Country:US
Mailing Address - Phone:704-688-7588
Mailing Address - Fax:704-899-4608
Practice Address - Street 1:10230 BERKELEY PLACE DR STE 200
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28262-1203
Practice Address - Country:US
Practice Address - Phone:704-688-7588
Practice Address - Fax:704-899-4608
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-13
Last Update Date:2023-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental