Individual provider Active NPI

Jesutomi Ojeleye, D.D.S.

  • Dentist
  • Wichita, KS
National Provider Identifier
1417346909
Registry record updated Aug 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
62259 Issued in KS
Practice address
13705 W Maple St
Wichita, KS 67235-8701
Phone
(316) 201-6323
NPI assigned
Jan 21, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 28, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 019.29873 IL
Dentist 122300000X 2015029032 MO
Dentist 122300000X 62259 KS Primary

Addresses

Primary practice location

13705 W Maple St
Wichita, KS 67235-8701

Mailing address

3550 N Tyler CT
Wichita, KS 67205-6407
Phone (785) 248-1933

Other practice location 1

501 S Madison St
Webb City, MO 64870-2502
Phone (417) 392-6090

Other practice location 2

2040 La Questa Dr
Neosho, MO 64850-2833
Phone (417) 451-1566

Other practice location 3

333 S Kyler St
Monett, MO 65708-2603
Phone (417) 635-1173

Other practice location 4

2800 College Ave
Alton, IL 62002-4742
Phone (785) 248-1933

Other practice location 5

10333 E 21st St N Ste 101
Wichita, KS 67206-3544
Phone (316) 684-1470

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20160218001721 MO Order and Referring Only - Other (Physician)Practitioner - Other (Physician) 8729383302

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
019.29873ILMDDentist
62259KSMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1421798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756339200000",
    "number": "1417346909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3550 N TYLER CT",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672056407",
            "telephone_number": "785-248-1933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13705 W MAPLE ST",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672358701",
            "telephone_number": "316-201-6323"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "501 S Madison St",
            "address_purpose": "LOCATION",
            "city": "Webb City",
            "state": "MO",
            "postal_code": "648702502",
            "country_code": "US",
            "telephone_number": "417-392-6090",
            "fax_number": "417-673-3331",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2040 La Questa Dr",
            "address_purpose": "LOCATION",
            "city": "Neosho",
            "state": "MO",
            "postal_code": "648502833",
            "country_code": "US",
            "telephone_number": "417-451-1566",
            "fax_number": "417-451-5262",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "333 S Kyler St",
            "address_purpose": "LOCATION",
            "city": "Monett",
            "state": "MO",
            "postal_code": "657082603",
            "country_code": "US",
            "telephone_number": "417-635-1173",
            "fax_number": "417-451-1174",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2800 College Ave",
            "address_purpose": "LOCATION",
            "city": "Alton",
            "state": "IL",
            "postal_code": "620024742",
            "country_code": "US",
            "telephone_number": "785-248-1933",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10333 E 21st St N Ste 101",
            "address_purpose": "LOCATION",
            "city": "Wichita",
            "state": "KS",
            "postal_code": "672063544",
            "country_code": "US",
            "telephone_number": "316-684-1470",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OJELEYE",
        "first_name": "JESUTOMI",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-01-21",
        "last_updated": "2025-08-28",
        "certification_date": "2025-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019.29873",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MO",
            "license": "2015029032",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "KS",
            "license": "62259",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita, KS

Sources for this page

Verify at the official NPI Registry.