Oduyelu, Olubukunola A

Oduyelu, Olubukunola A is an individual health care provider with primary practice located at 2125 Mccomas Way Suite 105, Virginia Beach VA 23456-3986. He recently has only one registered license in Dental Providers / Pediatric Dentistry, which is considered as his primary health care specialty. Oduyelu, Olubukunola A can be contacted via phone (757) 563-2670.

Contact Information

Primary practice address
2125 Mccomas Way Suite 105 Virginia Beach VA 23456-3986
Fax: (757) 563-2851
Website:

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Pediatric Dentistry 1223P0221X 0401008828 Virginia

Profile Details

NPI number 1700840816
LBN Legal business name Oduyelu, Olubukunola A
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 14th, 2006
Last updated Jul 8th, 2007 - about 18 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 1700840816 NPPES
Virginia MEDICAID 7803770
Virginia MEDICAID 8990133

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