Provider Demographics
NPI:1700181880
Name:UKA, NDIDI (DDS)
Entity type:Individual
Prefix:DR
First Name:NDIDI
Middle Name:
Last Name:UKA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:NDIDI
Other - Middle Name:
Other - Last Name:UKA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:3756 SANTA ROSALIA DR
Mailing Address - Street 2:#517
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90008-3606
Mailing Address - Country:US
Mailing Address - Phone:323-298-7992
Mailing Address - Fax:
Practice Address - Street 1:3756 SANTA ROSALIA DR
Practice Address - Street 2:SUITE 517
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90008-3606
Practice Address - Country:US
Practice Address - Phone:323-298-7992
Practice Address - Fax:323-298-7993
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-20
Last Update Date:2024-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA796011223S0112X
172V00000X, 261QC1500X, 261QM0801X, 261QR0401X, 310500000X, 320800000X, 320900000X, 324500000X, 332B00000X, 385H00000X, 385HR2050X
CA60123122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentist
No1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
No172V00000XOther Service ProvidersCommunity Health WorkerGroup - Multi-Specialty
No261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QR0401XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)
No310500000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Mental Illness
No320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness
No320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
No324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No385H00000XRespite Care FacilityRespite Care
No385HR2050XRespite Care FacilityRespite CareRespite Care Camp