Oludamilola Adetokunbo Ademidun, DDS
Individual provider Active NPI General Practice Dentistry · Merriam, KS
NPI 1093336893 · NPPES record last updated Nov 30, 2020
Key facts
- NPI
- 1093336893
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 61739 (KS)
- Practice address
- 5754 Antioch Rd
Merriam, KS 66202-2015 - Phone
- (913) 671-7066
- NPI assigned
- May 3, 2020
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Antioch Dentistry PA | General Practice | Current |
Accepting new patients |
Locations
5754 Antioch Rd
Merriam, KS 66202
Phone (913) 671-7066
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry |
1223G0001X | 61739 | KS | Yes |
Addresses
Primary practice location
5754 Antioch Rd
Merriam, KS 66202-2015
Mailing address
7941 Carter St Apt 3002
Overland Park, KS 66204-1387
Phone (917) 635-6312
Other providers in Merriam, KS
- Katherine I Aberle
- Jill M Ackerman
- Adventhealth Home Health and Hospice Inc
- Adventhealth Home Health and Hospice Inc
- Adventhealth Primary Care Mar
- Wilberforce Afuya
- Shannon Akers
All providers in Merriam, KS · General Practice Dentistry in Kansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 30, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.