Individual provider Active NPI

Anthony Olatunji, D.M.D

  • General Practice Dentistry
  • Los Angeles, CA
National Provider Identifier
1932267390
Registry record updated Dec 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
109702 Issued in CA
Practice address
11900 Avalon Blvd Ste 101
Los Angeles, CA 90061-2867
Phone
(310) 331-8134
Fax
(310) 747-5273
NPI assigned
Dec 5, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 23, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 19621 MA
General Practice Dentistry 1223G0001X 109702 CA Primary

Addresses

Primary practice location

11900 Avalon Blvd Ste 101
Los Angeles, CA 90061-2867

Mailing address

1510 W Artesia SQ Apt C
Gardena, CA 90248-4768
Phone (781) 774-9885

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251105000188 CA Practitioner - DentistPractitioner - Oral SurgeryPractitioner - Endodontics 9436562964 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
DentistAlso: Endodontics, Oral Surgery
Education
Boston Univ Goldman School of Dental Medicine, 1998
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

11900 Avalon Blvd
Suite 101
Los Angeles, CA 90061-2866

1510 W Artesia SQ
Apt C
Gardena, CA 90248-4768

1510 W Artesia SQ Apt C
Gardena, CA 90248-4768

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
109702CAMDGeneral Practice Dentistry
19621MAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Anthony Olatunji Smiles DMD Inc General Practice CurrentSince Oct 17, 2025 Accepting new patients
El Shaddai Dental General Practice Past Accepting new patients

Locations

11340 W Olympic Blvd
Ste 337
Los Angeles, CA 90064
Phone (310) 479-8900

11900 Avalon Blvd
Ste 101
Los Angeles, CA 90061
Phone (310) 331-8134

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766448000000",
    "number": "1932267390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1510 W ARTESIA SQ APT C",
            "city": "GARDENA",
            "state": "CA",
            "postal_code": "902484768",
            "telephone_number": "781-774-9885",
            "fax_number": "310-747-5273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11900 AVALON BLVD STE 101",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900612867",
            "telephone_number": "310-331-8134",
            "fax_number": "310-747-5273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLATUNJI",
        "first_name": "ANTHONY",
        "credential": "D.M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-05",
        "last_updated": "2025-12-23",
        "certification_date": "2025-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "19621",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "109702",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.