Olurotimi Adedapo Ogundipe, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

12013992A Issued in IN

Practice address

4716 Illinois Rd Ste 101
Fort Wayne, IN 46804-5123

Phone

(260) 432-7970

NPI assigned

Nov 9, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

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

Practice roles

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.

• D2 Dental of Michigan, P.C.

  • General Practice Dentistry
  • Kalamazoo, MI
  • NPI 1831508548
  NPD (past)
• Pro Dental Mi 1 PC

  dba Destiny Dental of Kalamazoo

  • General Practice Dentistry
  • Kalamazoo, MI
  • NPI 1164259438
  NPD (past)

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

{
    "created_epoch": "1604880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676505600000",
    "number": "1659972362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2804 CORLEE CRES",
            "city": "BROWNSBURG",
            "state": "IN",
            "postal_code": "461127208",
            "telephone_number": "202-460-2597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4716 ILLINOIS RD STE 101",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468045123",
            "telephone_number": "260-432-7970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OGUNDIPE",
        "first_name": "OLUROTIMI",
        "middle_name": "ADEDAPO",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-11-09",
        "last_updated": "2023-02-16",
        "certification_date": "2023-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IN",
            "license": "12013992A",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901600564",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tessa Felice Offerle
• Christopher Ibe Ogbogu, MD
• Chinelo Ogbudinkpa, M.D
• Brittany Ogden, MSW, LCSW, CSAYC
• Amanda M. Ogilvy, OTR
• Kayleigh Ohair
• Angela R Ojeda, DDS
• Felix A Okah, MD
• Cassidy J Okai, NP
• Kingsley Saahene Okai, MD

• Dentist in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Dentist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2023; 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.