Individual provider Active NPI

Akintunde Olaniyi Ojo, DDS

  • General Practice Dentistry
  • Converse, TX
National Provider Identifier
1215464557
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
33069 Issued in TX
Practice address
9160 FM 78 Ste 1B
Converse, TX 78109-2040
Phone
(210) 672-4610
NPI assigned
May 17, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
General Practice Dentistry 1223G0001X 33069 TX Primary

Addresses

Primary practice location

9160 FM 78 Ste 1B
Converse, TX 78109-2040

Mailing address

6974 Oak Dr Apt 6101
San Antonio, TX 78256-4425
Phone (773) 414-2307

Other practice location 1

1011 N University Ave
Ann Arbor, MI 48109-1078
Phone (734) 763-6933

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20200629003153 TX Practitioner - Dentist 7012339526

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1494979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1215464557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6974 OAK DR APT 6101",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782564425",
            "telephone_number": "773-414-2307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9160 FM 78 STE 1B",
            "city": "CONVERSE",
            "state": "TX",
            "postal_code": "781092040",
            "telephone_number": "210-672-4610"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1011 N University Ave",
            "address_purpose": "LOCATION",
            "city": "Ann Arbor",
            "state": "MI",
            "postal_code": "481091078",
            "country_code": "US",
            "telephone_number": "734-763-6933",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OJO",
        "first_name": "AKINTUNDE",
        "middle_name": "OLANIYI",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-17",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "33069",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Converse, TX

Sources for this page

Verify at the official NPI Registry.