Basic Information
| Provider Information | |||||||||
| NPI: | 1194383422 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MBADIWE | ||||||||
| FirstName: | CHINYERE | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | DDS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 100 FLORIDA AVE NE APT 429 | ||||||||
| Address2: | |||||||||
| City: | WASHINGTON | ||||||||
| State: | DC | ||||||||
| PostalCode: | 200023279 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2028484558 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 9245 RAINIER AVE S | ||||||||
| Address2: | |||||||||
| City: | SEATTLE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 981185569 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2067228444 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/02/2019 | ||||||||
| LastUpdateDate: | 06/02/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | Y | Student, Health Care | Student in an Organized Health Care Education/Training Program |
No ID Information.