Active NPI
Olamide Osundolu Atanda, DMD
- Pediatric Dentistry
- Miami, FL
National Provider Identifier
1245528686
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- DN19467
- Practice address
- 5607 NW 27TH Ave Ste 2
Miami, FL 33142-2826 - Phone
- (305) 637-6400
- Fax
- (305) 636-5155
- NPI assigned
- Jul 19, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | 30734 | TX | |
| Periodontics | 1223P0300X | DN19467 | FL | |
| Pediatric Dentistry | 1223P0221X | DN19467 | FL | Primary |
Addresses
Primary practice location
5607 NW 27TH Ave Ste 2
Miami, FL 33142-2826
Mailing address
5607 NW 27TH Ave Ste 1
Miami, FL 33142-2826
Phone (305) 805-1700
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| NPI | Other | FL | 1245528686 |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 30734 | TX | MD | Clinical Child & Adolescent Psychologist |
| DN19467 | FL | MD | Pediatric Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sugar Land Modern Dentistry, PC | Past | Accepting new patients |
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.
-
- General Practice Dentistry
- Sugar Land, TX
- NPI 1033410568
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1311033600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1644364800000",
"number": "1245528686",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5607 NW 27TH AVE STE 1",
"city": "MIAMI",
"state": "FL",
"postal_code": "331422826",
"telephone_number": "305-805-1700",
"fax_number": "305-805-1715"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5607 NW 27TH AVE STE 2",
"city": "MIAMI",
"state": "FL",
"postal_code": "331422826",
"telephone_number": "305-637-6400",
"fax_number": "305-636-5155"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ATANDA",
"first_name": "OLAMIDE",
"middle_name": "OSUNDOLU",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-07-19",
"last_updated": "2022-02-09",
"certification_date": "2022-02-09",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "TX",
"license": "30734",
"primary": false
},
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "FL",
"license": "DN19467",
"primary": false
},
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "FL",
"license": "DN19467",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "1245528686",
"identifier": "NPI",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Miami, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.