Mofolusara O Ogunfusika, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

13036 Issued in MD

Practice address

9614 Pennsylvania Ave
Upper Marlboro, MD 20772-3670

Phone

(301) 599-0404

Fax

(301) 599-0400

NPI assigned

Aug 3, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Avalon Dental Center, Inc

  • Dental Clinic/Center
  • Upper Marlboro, MD
  • NPI 1407629173
  NPD Authorized official

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

{
    "created_epoch": "1154563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491264000000",
    "number": "1740298371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9614 MARLBORO PIKE",
            "city": "UPPER MARLBORO",
            "state": "MD",
            "postal_code": "207723670",
            "telephone_number": "301-599-0404",
            "fax_number": "301-599-0400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9614 PENNSYLVANIA AVE",
            "city": "UPPER MARLBORO",
            "state": "MD",
            "postal_code": "207723670",
            "telephone_number": "301-599-0404",
            "fax_number": "301-599-0400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OGUNFUSIKA",
        "first_name": "MOFOLUSARA",
        "middle_name": "O",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-03",
        "last_updated": "2017-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MD",
            "license": "13036",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "DC",
            "license": "DEN1000990",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTAL LICENSE",
            "identifier": "DEN1000990",
            "state": "DC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ofe Medical Associates Inc.
• Herrmann Abit Asah Njwe Ofeh
• Bolanle Oluwatosin Ogunbona Anyantuga
• Adetoun Ogundana
• Francis Ogundokun, HHA
• Oyindamola Ogunlana, HHA
• Oyebisi Oyefunmike Ogunleye, PMHNP
• Badatunde Ogunsola
• Oh My Words Therapy Services LLC
• Bethrand Ibeh Ohakweh, PHARM. D, B. SC.

• Dentist in Upper Marlboro, MD
• Providers in Upper Marlboro, MD by specialty
• Dentist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2017; 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.