Provider Demographics
NPI:1609606284
Name:ADEKOYA, ADEWALE DAVID (DMD)
Entity type:Individual
Prefix:
First Name:ADEWALE
Middle Name:DAVID
Last Name:ADEKOYA
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:224 STONECREST CIR
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37209-5272
Mailing Address - Country:US
Mailing Address - Phone:240-281-6752
Mailing Address - Fax:
Practice Address - Street 1:2335 8TH AVE S
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37204-2252
Practice Address - Country:US
Practice Address - Phone:615-334-5041
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-07
Last Update Date:2024-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN126011223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice