Active NPI
Adenike P Taiwo, D.M.D
- Dentist
- Gainesville, FL
National Provider Identifier
1245543438
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 32682
- Practice address
- 5021 NW 34TH St
Gainesville, FL 32605-6121 - Phone
- (352) 371-7766
- NPI assigned
- Jul 16, 2010
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DN18798 | FL | |
| Dentist | 122300000X | 32682 | TX | Primary |
Addresses
Primary practice location
5021 NW 34TH St
Gainesville, FL 32605-6121
Mailing address
1200 Paluxy Medical Cir
Ste 101
Granbury, TX 76048-5696
Phone (817) 573-8338
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 |
|---|---|---|---|
| 32682 | TX | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lake Granbury Dental & Orthodontics PLLC | General Practice | 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
- Granbury, TX
- NPI 1942579602
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1279238400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1489363200000",
"number": "1245543438",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1200 PALUXY MEDICAL CIR",
"address_2": "STE 101",
"city": "GRANBURY",
"state": "TX",
"postal_code": "760485696",
"telephone_number": "817-573-8338"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5021 NW 34TH ST",
"city": "GAINESVILLE",
"state": "FL",
"postal_code": "326056121",
"telephone_number": "352-371-7766"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TAIWO",
"first_name": "ADENIKE",
"middle_name": "P",
"name_prefix": "Dr.",
"credential": "D.M.D",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-07-16",
"last_updated": "2017-03-13",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "FL",
"license": "DN18798",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "TX",
"license": "32682",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gainesville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.