Provider Demographics
NPI:1235814864
Name:ENYINNIA, DIAMOND OLUCHI (DDS)
Entity type:Individual
Prefix:DR
First Name:DIAMOND
Middle Name:OLUCHI
Last Name:ENYINNIA
Suffix:
Gender:
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11523 BOB WHITE DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77035-2203
Mailing Address - Country:US
Mailing Address - Phone:713-269-1264
Mailing Address - Fax:
Practice Address - Street 1:3103 CLAIRMONT RD NE STE C
Practice Address - Street 2:
Practice Address - City:BROOKHAVEN
Practice Address - State:GA
Practice Address - Zip Code:30329-1043
Practice Address - Country:US
Practice Address - Phone:404-942-0086
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-20
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN1233971223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice