Provider Demographics
NPI:1982714705
Name:OBIANWU, CHILO N (DMD)
Entity type:Individual
Prefix:DR
First Name:CHILO
Middle Name:N
Last Name:OBIANWU
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 1:3847 BRANCH AVE STE 124
Mailing Address - Street 2:
Mailing Address - City:TEMPLE HILLS
Mailing Address - State:MD
Mailing Address - Zip Code:20748-1407
Mailing Address - Country:US
Mailing Address - Phone:301-702-4080
Mailing Address - Fax:301-702-4081
Practice Address - Street 1:3847 BRANCH AVE STE 124
Practice Address - Street 2:
Practice Address - City:TEMPLE HILLS
Practice Address - State:MD
Practice Address - Zip Code:20748-1407
Practice Address - Country:US
Practice Address - Phone:301-702-4080
Practice Address - Fax:301-702-4081
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2022-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCDEN10005741223G0001X
MD138261223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice