Kole-James, Kishawn Olasupo

Kole-James, Kishawn Olasupo is an individual health care provider with primary practice located at 1799 E Grand Blvd , Detroit MI 48211-3145. He recently has 2 registered licenses in different health care specialties including Dental Providers / General Practice, Dental Providers / Orthodontics and Dentofacial Orthopedics. Dental Providers / Orthodontics and Dentofacial Orthopedics is his primary health care specialty. Kole-James, Kishawn Olasupo can be contacted via phone (313) 282-5651.

Contact Information

Primary practice address
1799 E Grand Blvd Detroit MI 48211-3145
Phone: (313) 282-5651
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 2901019444 Michigan
Dental Providers / Orthodontics and Dentofacial Orthopedics 1223X0400X 19444 Michigan

Profile Details

NPI number 1073688818
LBN Legal business name Kole-James, Kishawn Olasupo
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 21st, 2006
Last updated Sep 30th, 2022 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1073688818 NPPES
Michigan MEDICAID 4935200

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