Provider Demographics
NPI:1043667785
Name:ONUKWUGHA, SANDRA (DMD)
Entity type:Individual
Prefix:DR
First Name:SANDRA
Middle Name:
Last Name:ONUKWUGHA
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:PO BOX 524
Mailing Address - Street 2:
Mailing Address - City:AVENEL
Mailing Address - State:NJ
Mailing Address - Zip Code:07001-0524
Mailing Address - Country:US
Mailing Address - Phone:732-545-5364
Mailing Address - Fax:732-545-5678
Practice Address - Street 1:330 LIVINGSTON AVE STE 3
Practice Address - Street 2:
Practice Address - City:NEW BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08901-3469
Practice Address - Country:US
Practice Address - Phone:732-545-5364
Practice Address - Fax:732-545-5678
Is Sole Proprietor?:No
Enumeration Date:2016-05-23
Last Update Date:2024-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI026624001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice