Provider Demographics
NPI:1871904516
Name:AKINWANDE, AKINWALE (DDS)
Entity type:Individual
Prefix:DR
First Name:AKINWALE
Middle Name:
Last Name:AKINWANDE
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 1:2401 BELAIR RD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21213-1200
Mailing Address - Country:US
Mailing Address - Phone:410-522-5777
Mailing Address - Fax:
Practice Address - Street 1:2401 BELAIR RD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21213-1200
Practice Address - Country:US
Practice Address - Phone:410-522-5777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-15
Last Update Date:2017-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30.024264122300000X
MD16231122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist