Provider Demographics
NPI:1447272380
Name:ADEDOYIN, OLAJUMOKE O (DDS)
Entity type:Individual
Prefix:DR
First Name:OLAJUMOKE
Middle Name:O
Last Name:ADEDOYIN
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 1:4484 JIMMY LEE SMITH PKWY
Mailing Address - Street 2:SUITE E114
Mailing Address - City:HIRAM
Mailing Address - State:GA
Mailing Address - Zip Code:30141-2737
Mailing Address - Country:US
Mailing Address - Phone:770-222-7818
Mailing Address - Fax:770-222-7828
Practice Address - Street 1:4484 JIMMY LEE SMITH PKWY
Practice Address - Street 2:SUITE E114
Practice Address - City:HIRAM
Practice Address - State:GA
Practice Address - Zip Code:30141-2737
Practice Address - Country:US
Practice Address - Phone:770-222-7818
Practice Address - Fax:770-222-7828
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0124431223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00921621HMedicaid