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Contact Information

CHIZOBAM N IDAHOSA, D.D.S., M.S.
1151 S BROAD ST
LANSDALE, PA19446-5340
 Phone: 215-220-3395
 Fax: 267-449-0644
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Oral Medicinist

125Q00000X
 

General Practice

1223G0001X
 

Orofacial Pain

1223X2210X
Indicates primary specialty

NPI Profile & details for CHIZOBAM N IDAHOSA · (Female)

NPI Number 1669781274
Status Active
Credentials D.D.S., M.S.
Entity Individual
Enumeration date 09/29/2010
Last updated 06/03/2025 - More than a year ago
Sole proprietor 1 No
Identifiers
  • PA License # DS038657
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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