Olufemi Fadahunsi, DDS, PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DS0000009689 Issued in TN

Legal business name

OLUFEMI FADAHUNSI, DDS, PC

Doing business as

Wylie Dentistry Company

Practice address

2810 W. Fm544
Suite 100
Wylie, TX 75098

Phone

(800) 888-8888

NPI assigned

Apr 30, 2018

Last updated

Apr 30, 2018By 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

Olufemi Fadahunsi, DDS

Title

Dentist/Owner

Phone

(469) 231-3323

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Wylie Dentistry Company Doing business as

Locations

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

{
    "created_epoch": "1525046400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1525046400000",
    "number": "1619465234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14667 KELMSCOT DR",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750357291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2810 W. FM544",
            "address_2": "SUITE 100",
            "city": "WYLIE",
            "state": "TX",
            "postal_code": "75098",
            "telephone_number": "800-888-8888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OLUFEMI FADAHUNSI, DDS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-30",
        "last_updated": "2018-04-30",
        "status": "A",
        "authorized_official_last_name": "FADAHUNSI",
        "authorized_official_first_name": "OLUFEMI",
        "authorized_official_title_or_position": "DENTIST/OWNER",
        "authorized_official_telephone_number": "469-231-3323",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TN",
            "license": "DS0000009689",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1427497130",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wylie Dentistry Company",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Wylie Dentistry Company",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• General Practice Dentistry in Wylie, TX
• Providers in Wylie, 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 Apr 30, 2018; 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.