Omoteniola Awofolu DDS. LLC

Primary specialty

DentistTaxonomy code 122300000X

License

14929 Issued in MD

Legal business name

OMOTENIOLA AWOFOLU DDS. LLC

Doing business as

Advanced Dental Care of Baltimore

Practice address

3407 Wilkens Ave
Suite 205
Baltimore, MD 21229-5072

Phone

(410) 525-0555

Fax

(410) 525-1055

NPI assigned

Jan 6, 2014

Last updated

Jan 6, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Omoteniola Awofolu, DDSNPI 1649574203

Title

Owner

Phone

(410) 525-0555

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Advanced Dental Care of Baltimore Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Omoteniola Desiree Awofolu, DDS

  • General Practice Dentistry
  • Baltimore, MD
  • NPI 1649574203
  NPD (past) Authorized official

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

{
    "created_epoch": "1388966400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1388966400000",
    "number": "1417379777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3407 WILKENS AVE",
            "address_2": "SUITE 205",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212295072",
            "telephone_number": "410-525-0555",
            "fax_number": "410-525-1055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3407 WILKENS AVE",
            "address_2": "SUITE 205",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212295072",
            "telephone_number": "410-525-0555",
            "fax_number": "410-525-1055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OMOTENIOLA AWOFOLU DDS. LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-06",
        "last_updated": "2014-01-06",
        "status": "A",
        "authorized_official_last_name": "AWOFOLU",
        "authorized_official_first_name": "OMOTENIOLA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "410-525-0555",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "MD",
            "license": "14929",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "051736400",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advanced Dental Care of Baltimore",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Nkechi Omorodion
• Collette Adesuwa Omorogbe, PMHNP-BC
• Richard E Omorogbe, SOCIAL WORKER, LCSWC
• Michael Oluwaseun Omosule, MBBS
• Aderonke Oluyemisi Omotade, M.D.
• Roselyn Oluwaseyi Omotosho
• Samson A Omotosho
• Oluranti A Omoyeni, ACNP,CRNP
• Kathryn Rose Richardson Omron, MD
• On Common Ground Counseling

• Dentist in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Dentist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.