Julio E Obando, DDS

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

35867 Issued in TX

Practice address

2525 Wycliff Ave
Dallas, TX 75219-2551

Phone

(214) 219-3719

NPI assigned

Jun 2, 2017

Last updated

Aug 6, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1496361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596672000000",
    "number": "1841728839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2525 WYCLIFF AVE",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752192551",
            "telephone_number": "312-415-9551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 WYCLIFF AVE",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752192551",
            "telephone_number": "214-219-3719"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15510 Livernois Ave",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "482381343",
            "country_code": "US",
            "telephone_number": "313-863-2800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OBANDO",
        "first_name": "JULIO",
        "middle_name": "E",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-02",
        "last_updated": "2020-08-06",
        "certification_date": "2020-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "MI",
            "license": "2901022167",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "TX",
            "license": "35867",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Ayuk Obale
• Justin Obana, O.D.
• Osahon Osarumen Obanor
• Daffney Veals Obare
• Eki Jennifer Obazee
• Olivia Obazughanmwen, APRN, FNP-C
• Carly Oberdieck, PHARMD

• Periodontics in Dallas, TX
• Providers in Dallas, TX by specialty
• Periodontics in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2020; 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.