Irene Ebunoluwa Apata, D.D.S
Individual provider Active NPI Pediatric Dentistry · Crofton, MD
NPI 1831452648 · NPPES record last updated Sep 11, 2023
Key facts
- NPI
- 1831452648
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatric Dentistry 1223P0221X
- License
- 15030 (MD)
- Practice address
- 1631 Crofton Ctr
Crofton, MD 21114-1343 - Phone
- (410) 774-0221
- Fax
- (410) 774-0251
- NPI assigned
- Jun 18, 2012
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 15030 | MD | MD | Pediatric Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rock Kids Dental LLC | Pediatric Dentistry | Current |
Accepting new patients |
| Dr. David M. Vieth 2, PC | General Practice | Past | Accepting new patients |
| Winifred J Booker DDS PA | Pediatric Dentistry | Past |
Accepting new patients |
Locations
1631 Crofton Ctr
Crofton, MD 21114
Phone (410) 774-0221
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | 15030 | MD | Yes |
Addresses
Primary practice location
1631 Crofton Ctr
Crofton, MD 21114-1343
Mailing address
9199 Reisterstown Rd Ste 203a
Owings Mills, MD 21117-4514
Phone (410) 356-8572
Other practice location 1
9199 Reisterstown Rd Ste 203A
Owings Mills, MD 21117-4514
Phone (410) 356-8572
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| D76904 | Other | MD | CDS |
Other names
- Dr. Irene Ebunoluwa Ayoola
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All providers in Crofton, MD · Pediatric Dentistry in Maryland
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 11, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.