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

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
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
15030MDMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Rock Kids Dental LLC Pediatric Dentistry Current
since Sep 17, 2023
Accepting new patients
Dr. David M. Vieth 2, PC General Practice Past Accepting new patients
Winifred J Booker DDS PA Pediatric Dentistry Past
since Feb 1, 2022
Accepting new patients

Locations

1631 Crofton Ctr
Crofton, MD 21114
Phone (410) 774-0221

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
D76904OtherMDCDS

Other names

  • Dr. Irene Ebunoluwa Ayoola Former name

Other providers in Crofton, MD

All providers in Crofton, MD · Pediatric Dentistry in Maryland

Sources for this page

Verify at the official NPI Registry.