Provider Demographics
NPI:1285128017
Name:AKINYELE, IDOWU AKINTOKUNBO (DDS)
Entity type:Individual
Prefix:DR
First Name:IDOWU
Middle Name:AKINTOKUNBO
Last Name:AKINYELE
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 1:1250 PACKSADDLE TRL
Mailing Address - Street 2:
Mailing Address - City:PROSPER
Mailing Address - State:TX
Mailing Address - Zip Code:75078-9469
Mailing Address - Country:US
Mailing Address - Phone:940-595-5355
Mailing Address - Fax:
Practice Address - Street 1:517 E LAMAR ST
Practice Address - Street 2:
Practice Address - City:ROYSE CITY
Practice Address - State:TX
Practice Address - Zip Code:75189-3921
Practice Address - Country:US
Practice Address - Phone:940-595-5355
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-15
Last Update Date:2022-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX340171223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty