Provider Demographics
NPI:1083393474
Name:NWOGU, ALEXANDER UCHE (DDS)
Entity type:Individual
Prefix:MR
First Name:ALEXANDER
Middle Name:UCHE
Last Name:NWOGU
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4214 S FARM ROAD 135
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65810-3716
Mailing Address - Country:US
Mailing Address - Phone:417-289-0000
Mailing Address - Fax:
Practice Address - Street 1:4214 S FARM ROAD 135
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65810-3716
Practice Address - Country:US
Practice Address - Phone:417-289-0000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-13
Last Update Date:2025-08-07
Deactivation Date:2024-02-20
Deactivation Code:
Reactivation Date:2025-08-04
Provider Licenses
StateLicense IDTaxonomies
MO2025024518122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist