Individual provider Active NPI

Iseoluwa Adebola Adedeji, BDS, MPH

  • General Practice Dentistry
  • San Antonio, TX
National Provider Identifier
1427294438
Registry record updated Jun 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
24375 Issued in TX
Practice address
7703 Floyd Curl Dr
Uthscsa Department of Community Dentistry, MSC 7917
San Antonio, TX 78229-3901
Phone
(210) 567-3200
Fax
(210) 567-4587
NPI assigned
Dec 22, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health Dentistry 1223D0001X F-24375 TX
General Practice Dentistry 1223G0001X 24375 TX Primary

Addresses

Primary practice location

7703 Floyd Curl Dr
Uthscsa Department of Community Dentistry, MSC 7917
San Antonio, TX 78229-3901

Mailing address

5637 Caraway BND
San Antonio, TX 78238-2443
Phone (210) 379-0044

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

State licenses

LicenseStateTypeSpecialty
F-24375TXMDPublic Health Dentist
24375TXMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1229904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1371513600000",
    "number": "1427294438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5637 CARAWAY BND",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782382443",
            "telephone_number": "210-379-0044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7703 FLOYD CURL DR",
            "address_2": "UTHSCSA DEPARTMENT OF COMMUNITY DENTISTRY, MSC 7917",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293901",
            "telephone_number": "210-567-3200",
            "fax_number": "210-567-4587"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADEDEJI",
        "first_name": "ISEOLUWA",
        "middle_name": "ADEBOLA",
        "name_prefix": "Dr.",
        "credential": "BDS, MPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-12-22",
        "last_updated": "2013-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223D0001X",
            "taxonomy_group": "",
            "desc": "Dentist, Dental Public Health",
            "state": "TX",
            "license": "F-24375",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "24375",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2013; 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.