Active NPI
Taiwo Semilore Fakunle
- Dental Hygienist
- Fort Leonard Wood, MO
National Provider Identifier
1265144869
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- Practice address
- US Army Dental Activity 6958 Nebraska Ave
BLDG 1608
Fort Leonard Wood, MO 65473-9223 - Phone
- (573) 596-0408
- NPI assigned
- Dec 15, 2022
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | Primary |
Addresses
Primary practice location
US Army Dental Activity 6958 Nebraska Ave
BLDG 1608
Fort Leonard Wood, MO 65473-9223
Mailing address
US Army Dental Activity, 6958 Nebraska Ave
BLDG 1608
Fort Leonard Wood, MO 65473-9223
Phone (573) 596-0408
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)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1671062400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1676505600000",
"number": "1265144869",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "US ARMY DENTAL ACTIVITY, 6958 NEBRASKA AVE",
"address_2": "BLDG 1608",
"city": "FORT LEONARD WOOD",
"state": "MO",
"postal_code": "654739223",
"telephone_number": "573-596-0408"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "US ARMY DENTAL ACTIVITY 6958 NEBRASKA AVE",
"address_2": "BLDG 1608",
"city": "FORT LEONARD WOOD",
"state": "MO",
"postal_code": "654739223",
"telephone_number": "573-596-0408"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FAKUNLE",
"first_name": "TAIWO",
"middle_name": "SEMILORE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-12-15",
"last_updated": "2023-02-16",
"certification_date": "2023-02-13",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Leonard Wood, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.