Individual provider Active NPI

Abisoluwa O Adeyeye, DDS

  • Pediatric Dentistry
  • Plano, TX
National Provider Identifier
1891215273
Registry record updated Sep 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
35032 Issued in TX
Practice address
2100 Hedgcoxe Rd Ste 150
Plano, TX 75025-3103
Phone
(240) 441-9395
NPI assigned
Jun 26, 2017
Last updated
Sep 10, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 2017020498 MO
Pediatric Dentistry 1223P0221X 35032 TX Primary

Addresses

Primary practice location

2100 Hedgcoxe Rd Ste 150
Plano, TX 75025-3103

Mailing address

4013 Roswell St
Dallas, TX 75219-3510
Phone (240) 441-9395

Other practice location 1

3320 Rutger St
Saint Louis, MO 63104-1122
Phone (314) 977-8363

Other practice location 2

2100 Hedgcoxe Rd
Plano, TX 75025
Phone (240) 441-9395

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
2017020498MOMDDentist
35032TXMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Abi Adeyeye PLLC Current Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1498435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568073600000",
    "number": "1891215273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4013 ROSWELL ST",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752193510",
            "telephone_number": "240-441-9395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 HEDGCOXE RD STE 150",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750253103",
            "telephone_number": "240-441-9395"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3320 Rutger St",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631041122",
            "country_code": "US",
            "telephone_number": "314-977-8363",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2100 Hedgcoxe Rd",
            "address_purpose": "LOCATION",
            "city": "Plano",
            "state": "TX",
            "postal_code": "75025",
            "country_code": "US",
            "telephone_number": "240-441-9395",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ADEYEYE",
        "first_name": "ABISOLUWA",
        "middle_name": "O",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-26",
        "last_updated": "2019-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MO",
            "license": "2017020498",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "TX",
            "license": "35032",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plano, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2019; 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.