Opeyemi Ajayi, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

38084 Issued in TX

Practice address

100 Hudson Oaks Dr
Hudson Oaks, TX 76087-4712

Phone

(817) 717-9653

NPI assigned

Sep 1, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Glade Modern Dentistry and Orthodontics, PC

  • Dentist
  • Euless, TX
  • NPI 1295171536
  NPD (past)
• Smith & Smith Smile Studio, PC

  • General Practice Dentistry
  • Chicago, IL
  • NPI 1669656195
  NPD (past)

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

{
    "created_epoch": "1630454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692576000000",
    "number": "1376211755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 W GLADE RD STE 110",
            "city": "EULESS",
            "state": "TX",
            "postal_code": "760395419",
            "telephone_number": "817-358-2008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 HUDSON OAKS DR",
            "city": "HUDSON OAKS",
            "state": "TX",
            "postal_code": "760874712",
            "telephone_number": "817-717-9653"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AJAYI",
        "first_name": "OPEYEMI",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-09-01",
        "last_updated": "2023-08-21",
        "certification_date": "2023-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "319.022626",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "38084",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jodie Lynn Anderson, BSN, RNC-NIC
• Balanced Creations Physical Therapy, PLLC
• Samantha Rechele Caldwell
• Brittney Cardoza
• Jheen Cater

• Dentist in Hudson Oaks, TX
• Providers in Hudson Oaks, TX by specialty
• Dentist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.