Oluseyi Ayangade, D.D.S, M.S
Individual provider Active NPI Periodontics · Michigan City, IN
NPI 1922190883 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1922190883
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Periodontics 1223P0300X
- License
- 12009844 (IN)
- Practice address
- 332 Dunes Plaza
Michigan City, IN 46360-7342 - Phone
- (219) 871-7171
- NPI assigned
- Sep 29, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12009844 | IN | MD | Periodontist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Michigan City Family Dentistry | Periodontics | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Periodontics | 1223P0300X | 12009844 | IN | Yes |
Addresses
Primary practice location
332 Dunes Plaza
Michigan City, IN 46360-7342
Mailing address
332 Dunes Plaza
Michigan City, IN 46360-7342
Phone (219) 871-7171
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 20013440 | Medicaid | IN |
Other providers in Michigan City, IN
- Arond the Clock Beacon of Light Co
- Sami Atassi
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- Axess Clinic and Diagnostics LLC
- Creshinda Ayangade
- Ali Sayed Abdel Azeem
- William Han Bae
- Breghan Bailey Albers
- Margaret M Bailey
- Matthew W. Baker
All providers in Michigan City, IN · Periodontics in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. 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.