Oluwole Ajagbe, DDS
Individual provider Active NPI Dentist · Washington, DC
NPI 1154465714 · NPPES record last updated Dec 20, 2013
Key facts
- NPI
- 1154465714
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- DEN5263 (DC)
- Practice address
- 3636 16TH Street NW
Suite Ag 64
Washington, DC 20010 - Phone
- (202) 239-7108
- Fax
- (301) 515-7491
- NPI assigned
- Feb 16, 2007
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DEN5263 | DC | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Capital DME | Current | Accepting new patients | |
| Creative Smile Institute LLC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DEN5263 | DC | Yes |
Addresses
Primary practice location
3636 16TH Street NW
Suite Ag 64
Washington, DC 20010
Mailing address
3636 16TH St NW
Suite Ag 64
Washington, DC 20010-1146
Phone (202) 239-7108
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 016801200 | Medicaid | DC |
Other providers in Washington, DC
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- Lindsey Alicia Ajabshir
- Margaret Ajaegbu
- Funmilayo Esther Ajagemo
- Toba Ajagemo
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All providers in Washington, DC · Dentist in District of Columbia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 20, 2013. 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.