Individual provider Active NPI

Oluwatosin Tokede, DDS

  • Dentist
  • Goshen, IN
National Provider Identifier
1962980284
Registry record updated Jul 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
12013018A Issued in IN
Practice address
2909 County Home Rd
Goshen, IN 46526-5866
Phone
(973) 444-3784
NPI assigned
Jul 30, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 12013018A IN Primary

Addresses

Primary practice location

2909 County Home Rd
Goshen, IN 46526-5866

Mailing address

409 Woodknoll Dr Apt 803
Granger, IN 46530-4926
Phone (973) 444-3784

Other identifiers 1

IdentifierTypeStateIssuer
12013018AOtherININDIANA DENTAL BOARD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20260319003204 PA Practitioner - Dentist 5597249326 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dentist
Education
Other, 2018
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

110 S 17TH St
Harrisburg, PA 17104-1123

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12013018AINMDDentist

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": "1532908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532908800000",
    "number": "1962980284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "409 WOODKNOLL DR APT 803",
            "city": "GRANGER",
            "state": "IN",
            "postal_code": "465304926",
            "telephone_number": "973-444-3784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2909 COUNTY HOME RD",
            "city": "GOSHEN",
            "state": "IN",
            "postal_code": "465265866",
            "telephone_number": "973-444-3784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOKEDE",
        "first_name": "OLUWATOSIN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-30",
        "last_updated": "2018-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IN",
            "license": "12013018A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIANA DENTAL BOARD",
            "identifier": "12013018A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Goshen, IN

Sources for this page

Verify at the official NPI Registry.