Provider Demographics
NPI:1821975517
Name:OKHIRIA, EROMOSELE CLAUDELL (DDS)
Entity type:Individual
Prefix:
First Name:EROMOSELE
Middle Name:CLAUDELL
Last Name:OKHIRIA
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 1:510 LEXINGTON MANOR LN
Mailing Address - Street 2:
Mailing Address - City:EADS
Mailing Address - State:TN
Mailing Address - Zip Code:38028-8016
Mailing Address - Country:US
Mailing Address - Phone:901-270-1469
Mailing Address - Fax:
Practice Address - Street 1:6941 EASTCHASE LOOP
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36117-6876
Practice Address - Country:US
Practice Address - Phone:334-530-5000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-18
Last Update Date:2025-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALD.007560-C1122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist