Provider Demographics
NPI:1487391397
Name:AKINTONDE, CECILIA (DDS)
Entity type:Individual
Prefix:
First Name:CECILIA
Middle Name:
Last Name:AKINTONDE
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 1:420 PARK ST STE 101
Mailing Address - Street 2:
Mailing Address - City:BELMONT
Mailing Address - State:NC
Mailing Address - Zip Code:28012-3393
Mailing Address - Country:US
Mailing Address - Phone:704-755-4600
Mailing Address - Fax:
Practice Address - Street 1:3340 ROBINWOOD RD STE 140
Practice Address - Street 2:
Practice Address - City:GASTONIA
Practice Address - State:NC
Practice Address - Zip Code:28054-6689
Practice Address - Country:US
Practice Address - Phone:704-755-1900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-13
Last Update Date:2022-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC102721223P0221X
NC127061223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry