Provider Demographics
NPI:1417346909
Name:OJELEYE, JESUTOMI MERCY (DDS)
Entity type:Individual
Prefix:DR
First Name:JESUTOMI
Middle Name:MERCY
Last Name:OJELEYE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1303 PIN OAK CIR
Mailing Address - Street 2:
Mailing Address - City:OTTAWA
Mailing Address - State:KS
Mailing Address - Zip Code:66067-3276
Mailing Address - Country:US
Mailing Address - Phone:785-248-1933
Mailing Address - Fax:
Practice Address - Street 1:10333 E 21ST ST N STE 101
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67206-3544
Practice Address - Country:US
Practice Address - Phone:316-684-1470
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-01-21
Last Update Date:2024-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019.29873122300000X
MO2015029032122300000X
KS62259122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist