Individual provider Active NPI

Omosede Osagiede, DMD

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Potomac, MD
National Provider Identifier
1962863902
Registry record updated Jun 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
18497 Issued in MD
Practice address
9812 Falls Rd Ste 118
Potomac, MD 20854-3918
Phone
(301) 983-9804
NPI assigned
Mar 18, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2025

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 12012596A IN
Dentist 122300000X 019.030571 IL
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 0401416046 VA
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 36656 TX
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 18497 MD Primary

Addresses

Primary practice location

9812 Falls Rd Ste 118
Potomac, MD 20854-3918

Mailing address

9812 Falls Rd Ste 118
Potomac, MD 20854-3918
Phone (301) 983-9804

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
019.030571ILMDDentist
12012596AINMDDentist
0401416046VAMDOrthodontics and Dentofacial Orthopedic Dentist
36656TXMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Amy Light, DMD, PC Orthodontics and Dentofacial Orthopedics PastSince Jun 23, 2025 Accepting new patients
South Texas Dental Associates, L.P. PastSince Sep 1, 2020 Accepting new patients
Brident Dental Associates PC Dentist PastSince Sep 1, 2020 Accepting new patients

Organizations & group practices 3

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": "1458259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750032000000",
    "number": "1962863902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9812 FALLS RD STE 118",
            "city": "POTOMAC",
            "state": "MD",
            "postal_code": "208543918",
            "telephone_number": "301-983-9804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9812 FALLS RD STE 118",
            "city": "POTOMAC",
            "state": "MD",
            "postal_code": "208543918",
            "telephone_number": "301-983-9804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OSAGIEDE",
        "first_name": "OMOSEDE",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-18",
        "last_updated": "2025-06-16",
        "certification_date": "2025-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IN",
            "license": "12012596A",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019.030571",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "VA",
            "license": "0401416046",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "TX",
            "license": "36656",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "MD",
            "license": "18497",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Potomac, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2025; 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.