Individual provider Active NPI

Adenike Ogunbekun, D.D.S., M.SC.

  • General Practice Dentistry
  • Manassas, VA
National Provider Identifier
1134327406
Registry record updated Oct 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
0401413225 Issued in VA
Practice address
9822 Liberia Ave
Manassas, VA 20110-5836
Phone
(703) 980-5981
Fax
(703) 496-5359
NPI assigned
Jul 6, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 25, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 0401413225 VA Primary

Addresses

Primary practice location

9822 Liberia Ave
Manassas, VA 20110-5836

Mailing address

12697 Victory Lakes Loop
Bristow, VA 20136-1274
Phone (585) 530-7402

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
0401413225VAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1183680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477353600000",
    "number": "1134327406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12697 VICTORY LAKES LOOP",
            "city": "BRISTOW",
            "state": "VA",
            "postal_code": "201361274",
            "telephone_number": "585-530-7402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9822 LIBERIA AVE",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201105836",
            "telephone_number": "703-980-5981",
            "fax_number": "703-496-5359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OGUNBEKUN",
        "first_name": "ADENIKE",
        "name_prefix": "Dr.",
        "credential": "D.D.S., M.SC.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-07-06",
        "last_updated": "2016-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401413225",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manassas, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2016; 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.