Individual provider Active NPI

Mulikat Adebimpe Adetosoye, DMD

  • Dentist
  • Katy, TX
National Provider Identifier
1962884908
Registry record updated Feb 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
31089 Issued in TX
Practice address
20501 Katy Fwy Ste 124
Katy, TX 77450-1940
Phone
(281) 206-7289
Fax
(832) 321-3957
NPI assigned
Jun 26, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 27, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 31089 TX Primary

Addresses

Primary practice location

20501 Katy Fwy Ste 124
Katy, TX 77450-1940

Mailing address

20501 Katy Fwy
Katy, TX 77450-1935
Phone (281) 206-7289

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
31089TXMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Soye Dental Spa PLLC Past 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1435276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708992000000",
    "number": "1962884908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20501 KATY FWY",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774501935",
            "telephone_number": "281-206-7289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20501 KATY FWY STE 124",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774501940",
            "telephone_number": "281-206-7289",
            "fax_number": "832-321-3957"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADETOSOYE",
        "first_name": "MULIKAT",
        "middle_name": "ADEBIMPE",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-06-26",
        "last_updated": "2024-02-27",
        "certification_date": "2024-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "31089",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Katy, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2024; 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.