Soteji T Adeuti, DMD

Individual provider Active NPI General Practice Dentistry · Spring, TX

NPI 1811558653 · NPPES record last updated Dec 24, 2021

Key facts

NPI
1811558653
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
35424 (TX)
Practice address
22618 Aldine Westfield Rd
Spring, TX 77373-6569
Phone
(936) 273-9423
NPI assigned
Jun 24, 2019
Sex
Female
Sole proprietor
No

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.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20240327002814 TX Order and Referring Only - Dentist
Practitioner - Dentist
1355788233

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
35424TXMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Adura Dentistry PLLC Current Accepting new patients

Locations

14320 FM 2920 Rd
Ste E
Tomball, TX 77377

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 35424 TX Yes

Addresses

Primary practice location

22618 Aldine Westfield Rd
Spring, TX 77373-6569

Mailing address

14320 FM 2920 Rd Ste E
Tomball, TX 77377-5572

Other providers in Spring, TX

All providers in Spring, TX · General Practice Dentistry in Texas

Sources for this page

Verify at the official NPI Registry.