Provider Demographics
NPI:1073329066
Name:O. SERIKI,DDS,PLLC
Entity type:Organization
Organization Name:O. SERIKI,DDS,PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:OLUTOSIN
Authorized Official - Middle Name:
Authorized Official - Last Name:SERIKI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:214-629-4412
Mailing Address - Street 1:KYHLIL G PALMER 3064 WAKE FOREST RD.
Mailing Address - Street 2:PO BOX #1272
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27609
Mailing Address - Country:US
Mailing Address - Phone:919-244-2995
Mailing Address - Fax:
Practice Address - Street 1:3735 DAVIS DR STE 125
Practice Address - Street 2:
Practice Address - City:MORRISVILLE
Practice Address - State:NC
Practice Address - Zip Code:27560-8907
Practice Address - Country:US
Practice Address - Phone:919-244-2995
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-05
Last Update Date:2024-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental