Funpedopark LLC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

FUNPEDOPARK LLC

Practice address

1009 Centerbrooke LN Ste 210
Suffolk, VA 23434-8664

Phone

(757) 767-7275

NPI assigned

Feb 6, 2020

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Olanrewaju Oye-Somefun, DDSNPI 1407291321

Title

Pediatric Dentist

Phone

(757) 767-7275

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Fun Park Pediatric Dentistry Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Olanrewaju Oye Somefun, D.D.S

  • Pediatric Dentistry
  • Suffolk, VA
  • NPI 1407291321
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1580947200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1600214400000",
    "number": "1043842214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1009 CENTERBROOKE LN STE 210",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234348664",
            "telephone_number": "757-767-7275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1009 CENTERBROOKE LN STE 210",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234348664",
            "telephone_number": "757-767-7275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FUNPEDOPARK LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-06",
        "last_updated": "2020-09-16",
        "certification_date": "2020-09-16",
        "status": "A",
        "authorized_official_last_name": "OYE-SOMEFUN",
        "authorized_official_first_name": "OLANREWAJU",
        "authorized_official_title_or_position": "PEDIATRIC DENTIST",
        "authorized_official_telephone_number": "757-767-7275",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTAL       LICENSE",
            "identifier": "0401416127",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fun Park Pediatric Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Raven Fulgham, FNP-C
• Whitnei S Fulgham, NP
• Linda Dianne Fuller, R.PH.
• Jenny Chan Fung, PHARMD
• Kathryn Elizabeth Funk, ACAGNP-BC
• Sharon 01 Furney, COTA
• Donald Ray Futrell, RPH
• Frances Yvonne Futrell, LPC
• Milton T Futrell Jr.
• Aprele Gaddie

• Pediatric Dentistry in Suffolk, VA
• Providers in Suffolk, VA by specialty
• Pediatric Dentistry in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.