Dr Chizobam Nkiru Idahosa, DDS, MS is a medicare enrolled "Oral Medicinist" provider in Philadelphia, Pennsylvania. Her current practice location is
240 S 40th St, Philadelphia, Pennsylvania. You can reach out to her office (for appointments etc.) via phone at
(215) 898-8965.
Dr Chizobam Nkiru Idahosa is licensed to practice in Pennsylvania (license number DS038657) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1669781274.
Healthcare Provider's Profile
Full Name | Dr Chizobam Nkiru Idahosa |
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Gender | Female |
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Speciality | Oral Medicinist |
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Location | 240 S 40th St, Philadelphia, Pennsylvania |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1669781274
- Provider Enumeration Date: 09/29/2010
- Last Update Date: 02/18/2023
Medicare PECOS Information:
- PECOS PAC ID: 3971807371
- Enrollment ID: I20160204002367
Medical Identifiers
Medical identifiers for Dr Chizobam Nkiru Idahosa such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1669781274 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
1223G0001X | Dentist - General Practice | DS038657 (Pennsylvania) | Secondary |
1223X2210X | Dentist - Orofacial Pain | DS038657 (Pennsylvania) | Secondary |
125Q00000X | Oral Medicinist | DS038657 (Pennsylvania) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Chizobam Nkiru Idahosa is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Dr Chizobam Nkiru Idahosa, DDS, MS 211 Chestnut Ln, North Wales, PA 19454-1303 Ph: (267) 984-2757 | Dr Chizobam Nkiru Idahosa, DDS, MS 240 S 40th St, Philadelphia, PA 19104-6030 Ph: (215) 898-8965 |
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