Provider Demographics
NPI:1215650452
Name:FALAIYE, OLUYEMI BRIDGET (DMD)
Entity type:Individual
Prefix:DR
First Name:OLUYEMI
Middle Name:BRIDGET
Last Name:FALAIYE
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1920 ZACK RD
Mailing Address - Street 2:
Mailing Address - City:MT JULIET
Mailing Address - State:TN
Mailing Address - Zip Code:37122-5121
Mailing Address - Country:US
Mailing Address - Phone:857-300-8562
Mailing Address - Fax:
Practice Address - Street 1:4054 LEBANON PIKE
Practice Address - Street 2:
Practice Address - City:HERMITAGE
Practice Address - State:TN
Practice Address - Zip Code:37076-2014
Practice Address - Country:US
Practice Address - Phone:615-647-8482
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-22
Last Update Date:2022-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN12054122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist