Individual provider Active NPI

Deji A Ogundiya, D.D.S.

  • Oral and Maxillofacial Surgery (Dentist)
  • Nashville, TN
National Provider Identifier
1184734386
Registry record updated Dec 7, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
DS 5165 Issued in TN
Practice address
1801 Church St
Nashville, TN 37203-2201
Phone
(615) 327-2494
NPI assigned
Aug 30, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 7, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X DS 5165 TN Primary

Addresses

Primary practice location

1801 Church St
Nashville, TN 37203-2201

Mailing address

1801 Church St
Nashville, TN 37203-2201
Phone (616) 327-2494

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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

Enrollment IDStateProvider typePAC IDDetails
I20101207000550 TN Practitioner - Oral Surgery 7810184587 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DS 5165TNMDOral and Maxillofacial Surgery (Dentist)

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Oral & Facial Surgery, PC Oral and Maxillofacial Surgery CurrentSince Aug 16, 2010 Accepting new patients

Locations

1801 Church St
Nashville, TN 37203
Phone (615) 327-2494

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1291680000000",
    "number": "1184734386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 CHURCH ST",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372032201",
            "telephone_number": "616-327-2494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 CHURCH ST",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372032201",
            "telephone_number": "615-327-2494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OGUNDIYA",
        "first_name": "DEJI",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2010-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "TN",
            "license": "DS 5165",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nashville, TN

Sources for this page

Verify at the official NPI Registry.