Oluleke S Jeboda, D.M.D,

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

32902 Issued in TX

Practice address

3616 S Lancaster Rd
Dallas, TX 75216-5629

Phone

(214) 374-7100

NPI assigned

Aug 4, 2006

Sex

Male

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

Practice roles

Locations

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

• Peridot Dental PLLC

  • Dental Clinic/Center
  • Dallas, TX
  • NPI 1083227904
  NPD Authorized official

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

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598572800000",
    "number": "1124036173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3616 S LANCASTER RD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752165629",
            "telephone_number": "217-374-7100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3616 S LANCASTER RD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752165629",
            "telephone_number": "214-374-7100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEBODA",
        "first_name": "OLULEKE",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "D.M.D,",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-04",
        "last_updated": "2020-08-28",
        "certification_date": "2020-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "32902",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gary Wayne Jean Jr., PHARM.D.
• Jeannine Rozas Cook, MD PA
• Jeb S. Miers M.D., P.a
• Joseph Suhail Jebain, MD
• Hazel Patricia Jebaraj
• Michael Scot Jebsen, PT
• Jeda Ride Transportation LLC
• Grace Syombua Jedidah
• Sangyoon Jee, DMD
• Jeff Nance, MD, PA

• General Practice Dentistry in Dallas, TX
• Providers in Dallas, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 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.