Oluwatoyin Abosede Oresanya

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN122786 Issued in GA

Practice address

509 N Tennessee St Ste 107
Cartersville, GA 30120-2890

Phone

(770) 407-8700

NPI assigned

Apr 26, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Marnita Stevenson DMD Holdings, LLC

  • General Practice Dentistry
  • Austell, GA
  • NPI 1265265698
  NPD (past)

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

{
    "created_epoch": "1650931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738540800000",
    "number": "1114661154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5128 TULIP SQ",
            "city": "ACWORTH",
            "state": "GA",
            "postal_code": "301011543",
            "telephone_number": "470-313-0894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "509 N TENNESSEE ST STE 107",
            "city": "CARTERSVILLE",
            "state": "GA",
            "postal_code": "301202890",
            "telephone_number": "770-407-8700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ORESANYA",
        "first_name": "OLUWATOYIN",
        "middle_name": "ABOSEDE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-26",
        "last_updated": "2025-02-03",
        "certification_date": "2025-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN122786",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Evelyn Nwangulor Ogbomoh, MD
• Ikenna Chikeziri Okpareke, M.D.
• Jordan Makayla Olsen Herron, MSN, FNP-C
• Omega Health Care of Northeast Georgia Inc
• Mina Akyeampong Opoku-Mensah, NP-C
• David Thornton Orr
• Orthoatlanta, LLC
• Daniel Andrew Ortiz, M.D.
• Igor Oruc, D.P.T
• Lauren Taylor Osborne, NP-C

• General Practice Dentistry in Cartersville, GA
• Providers in Cartersville, GA by specialty
• General Practice Dentistry in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.