Oluwasanmi Oloruntebi Adegboyega, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

7379 Issued in LA

Practice address

1514 Doctors Dr
Bossier City, LA 71111-3379

Phone

(318) 841-6023

NPI assigned

Jun 17, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: oluwasanmi.adegboyega.p1@direct.davidraineschc.nextgenshare.com

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

{
    "created_epoch": "1623888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663200000000",
    "number": "1831767656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1105 ISLAND PARK BLVD APT 801",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711054770",
            "telephone_number": "318-780-0428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1514 DOCTORS DR",
            "city": "BOSSIER CITY",
            "state": "LA",
            "postal_code": "711113379",
            "telephone_number": "318-841-6023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADEGBOYEGA",
        "first_name": "OLUWASANMI",
        "middle_name": "OLORUNTEBI",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-06-17",
        "last_updated": "2022-09-15",
        "certification_date": "2022-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "LA",
            "license": "7379",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charles Savage Adams, OD
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• Sondra Adams
• Jacquelyn E Adcock, P.A.
• Addus One Care LLC
• Advance One Medical Equipment & Supplies LLC.
• Affective Concepts, LLC.
• Affirming Solutions Counseling
• Gabriela Agront- Solano
• Hasan Ahmad

• General Practice Dentistry in Bossier City, LA
• Providers in Bossier City, LA by specialty
• General Practice Dentistry in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2022; 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.