Olakunle I Johnson

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

24029 Issued in TX

Practice address

5300 San Dario Ave # C-2
Laredo, TX 78041-3000

Phone

(956) 723-6568

Fax

(678) 904-5666

NPI assigned

Jul 11, 2008

Last updated

Oct 11, 2011By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

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

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Adonai Dental Clinic

  • General Practice Dentistry
  • Laredo, TX
  • NPI 1558699744
  Authorized official Same address or phone

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

{
    "created_epoch": "1215734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318291200000",
    "number": "1467616268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3210 JAIME ZAPATA MEMORIAL HIGHWAY",
            "address_2": "SUITE A6",
            "city": "LAREDO",
            "state": "TX",
            "postal_code": "78043",
            "telephone_number": "956-727-8200",
            "fax_number": "956-727-8202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5300 SAN DARIO AVE # C-2",
            "city": "LAREDO",
            "state": "TX",
            "postal_code": "780413000",
            "telephone_number": "956-723-6568",
            "fax_number": "678-904-5666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "OLAKUNLE",
        "middle_name": "I",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-07-11",
        "last_updated": "2011-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "24029",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Victor Francisco Jimenez Jr.
• JLG Health Group, LLC (United Home Health)
• Joann Shin DDS (Hollywood Dental)
• Joann Shin DDS Corporation (Laredo Family Dental)
• John C Britton DDS PC
• Johol C Chan DO PA
• Katelynn Nicole Jolly, M.ED. SLP
• Kenneth Neil Jones, M.D.
• Elva Villa Jordan, DDS
• Judith Ramos Jordan, LPC

• General Practice Dentistry in Laredo, TX
• Providers in Laredo, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2011; 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.