Individual provider Active NPI

Olubiyi Ogunjimi, DDS, MPH

  • Dentist
  • North Andover, MA
National Provider Identifier
1245469121
Registry record updated Jul 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN1856319 Issued in MA
Practice address
350 Winthrop Ave
North Andover, MA 01845-4289
Phone
(978) 794-0040
NPI assigned
Jul 13, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN1856319 MA Primary

Addresses

Primary practice location

350 Winthrop Ave
North Andover, MA 01845-4289

Mailing address

111 Middlesex Tpke # 1097
Burlington, MA 01803-4905
Phone (617) 690-8140

Other practice location 1

14 Loon Hill Rd
Dracut, MA 01826-4015
Phone (978) 955-9005

Other practice location 2

50 Staniford St Ste 804
Boston, MA 02114-2537
Phone (617) 581-0689

Other practice location 3

377 Main St
Watertown, MA 02472-2360
Phone (617) 923-8100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20160523000574 MA Order and Referring Only - DentistPractitioner - Dentist 4284923798

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN1856319MAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Advantage Dental Oral Health Center of Massachusetts, PC PastSince Sep 25, 2019 Accepting new patients
Ogunjimi Dental Holdings PLLC PastSince Aug 27, 2023 Accepting new patients
DRS Athanasoulas & Pappey Associates in Dentistry Ihc PastSince Sep 1, 2020 Accepting new patients
Frisco Custer Star Dental Group, PC PastSince Nov 1, 2019 Accepting new patients

Organizations & group practices 4

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": "1247443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785283200000",
    "number": "1245469121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 MIDDLESEX TPKE # 1097",
            "city": "BURLINGTON",
            "state": "MA",
            "postal_code": "018034905",
            "telephone_number": "617-690-8140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 WINTHROP AVE",
            "city": "NORTH ANDOVER",
            "state": "MA",
            "postal_code": "018454289",
            "telephone_number": "978-794-0040"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14 Loon Hill Rd",
            "address_purpose": "LOCATION",
            "city": "Dracut",
            "state": "MA",
            "postal_code": "018264015",
            "country_code": "US",
            "telephone_number": "978-955-9005",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "50 Staniford St Ste 804",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021142537",
            "country_code": "US",
            "telephone_number": "617-581-0689",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "377 Main St",
            "address_purpose": "LOCATION",
            "city": "Watertown",
            "state": "MA",
            "postal_code": "024722360",
            "country_code": "US",
            "telephone_number": "617-923-8100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OGUNJIMI",
        "first_name": "OLUBIYI",
        "credential": "DDS, MPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-13",
        "last_updated": "2026-07-29",
        "certification_date": "2026-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MA",
            "license": "DN1856319",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Andover, MA

Sources for this page

Verify at the official NPI Registry.