Individual provider Active NPI

Ayotunde Oluyomi Esho, DDS

  • Dentist
  • Odessa, TX
National Provider Identifier
1639418403
Registry record updated Jul 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
29843 Issued in TX
Practice address
603 E 6TH St
Odessa, TX 79761-4528
Phone
(432) 332-8300
NPI assigned
Feb 13, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 29843 TX Primary

Addresses

Primary practice location

603 E 6TH St
Odessa, TX 79761-4528

Mailing address

1403 San Miguel CT
Midland, TX 79705-2253
Phone (440) 715-0146

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
29843TXMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Basin Dental Suite PLLC CurrentSince Jul 25, 2021 Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1360713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626825600000",
    "number": "1639418403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1403 SAN MIGUEL CT",
            "city": "MIDLAND",
            "state": "TX",
            "postal_code": "797052253",
            "telephone_number": "440-715-0146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "603 E 6TH ST",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797614528",
            "telephone_number": "432-332-8300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESHO",
        "first_name": "AYOTUNDE",
        "middle_name": "OLUYOMI",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-02-13",
        "last_updated": "2021-07-21",
        "certification_date": "2021-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "29843",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Odessa, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2021; 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.