Provider Demographics
NPI:1215464557
Name:OJO, AKINTUNDE OLANIYI (DDS)
Entity type:Individual
Prefix:DR
First Name:AKINTUNDE
Middle Name:OLANIYI
Last Name:OJO
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6974 OAK DR APT 6101
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78256-4425
Mailing Address - Country:US
Mailing Address - Phone:773-414-2307
Mailing Address - Fax:
Practice Address - Street 1:9160 FM 78 STE 1B
Practice Address - Street 2:
Practice Address - City:CONVERSE
Practice Address - State:TX
Practice Address - Zip Code:78109-2040
Practice Address - Country:US
Practice Address - Phone:210-672-4610
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-17
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
TX330691223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program