DR. OLUWOLE FADAHUNSI (NPI# 1396123352) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396123352 |
| Entity Type | Individual |
| Full Name | DR. OLUWOLE FADAHUNSI |
| Credential | DMD |
| Practice Address |
11437 Olive Blvd Creve Coeur MO 63141-7108 |
| Practice Telephone | 3143552000 |
| Mailing Telephone | 3143552000 |
| Enumeration Date | 2015-05-11 |
| Last Update Date | 2019-07-16 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
DEN1001975 | DC | Dental Providers |
| N | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
0401416435 | VA | Dental Providers |
| N | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
16193 | MD | Dental Providers |
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
2019016472 | MO | Dental Providers |
| Street Address |
11437 OLIVE BLVD |
| City | CREVE COEUR |
| State | MO |
| Zip Code | 63141-7108 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699905547 | Jessica J. Lavalle | Dentist | 11437 Olive Blvd, Creve Coeur, MO 63141-7108 | 2009-07-24 |
| 1487295747 | Simrata Sandhu | Dentist | 11437 Olive Blvd, Creve Coeur, MO 63141-7108 | 2019-10-07 |
| 1598118945 | Reeya Patel | Dentist | 11437 Olive Blvd, Creve Coeur, MO 63141-7108 | 2016-07-21 |
| 1821487596 | Alex Sharifian D.d.s., Creve Coeur Dentistry, P.C. | Dentist | 11437 Olive Blvd, Creve Coeur, MO 63141-7108 | 2015-01-17 |
| 1962805846 | Ghina Samad | Dentist | 11437 Olive Blvd, Creve Coeur, MO 63141-7108 | 2014-10-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679102842 | Noor Ramadan | Pharmacist | 628 North New Ballad Road, Suite A, Creve Coeur, MO 63141 | 2020-04-08 |
| 1497381206 | Washington University | Durable Medical Equipment & Medical Supplies | 1044 North Mason Road, Suite 110/210, St. Louis, MO 63141 | 2020-03-13 |
| 1154956498 | Ashleigh Clendenny | Physician Assistant | Mercy Hospital St. Louis, 615 S New Ballas Rd, St. Louis, MO 63141 | 2020-03-06 |
| 1801429410 | Emili Lou Haley | Registered Nurse | 650 Maryville Drive, St Louis, MO 63141 | 2020-02-21 |
| 1629553110 | Rebecca Kathleen Pike | Social Worker | West County Psychological Associates, 12125 Woodcrest Executive Drive #110, St. Louis, MO 63141 | 2018-10-01 |
| 1649756099 | River City Sedation Associates, LLC | Nurse Anesthetist, Certified Registered | 12855 N 40 Dr Ste 150, Saint Louis, MO 63141 | 2018-07-18 |
| 1205333952 | Ear Care and Hearing of St. Louis | Hearing Aid Equipment | 11630 Studt Ave Ste 210, Creve Coeur, MO 63141 | 2018-04-10 |
| 1659897486 | Erin Goodman | Physical Therapist | 10560 Old Olive St. Rd, Suite 100, Creve Coeur, MO 63141 | 2017-08-14 |
| 1093230450 | Center for Urologic Surgery LLC | Clinic/Center | 12855 N 40 Dr Ste 100, Saint Louis, MO 63141 | 2017-08-07 |
| 1871016105 | Jacob Farley Tanner | Specialist/Technologist | 1054 Town and Four Parkway Dr, Creve Coeur, MO 63141 | 2017-07-19 |
| Find all providers in zip 63141 | ||||
| Taxonomy Code | 1223S0112X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Oral and Maxillofacial Surgery |
| The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720144678 | Marc Bruce Abrams | Dentist | 456 N New Ballas Rd, Suite 249, Creve Coeur, MO 63141-6831 | 2006-12-28 |
| 1144386004 | Kenneth Emil Kram | Dentist | 456 N New Ballas Rd, Suite 249, Creve Coeur, MO 63141-6831 | 2006-12-28 |
| 1205946787 | Oral and Maxillofacial Surgeons Inc | Dentist | 456 N New Ballas Rd, Suite 249, Creve Coeur, MO 63141-6831 | 2006-08-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881202943 | Kansas City Oral Surgery & Implant Center | Dentist | 8771 N Platte Purchase Dr, Kansas City, MO 64155-1829 | 2020-07-15 |
| 1700403722 | Kansas City Facial and Oral Surgery, LLC | Dentist | 2931 Ne Independence Ave., Lees Summit, MO 64064-6406 | 2020-06-26 |
| 1134767866 | Courtney Ethington | Dentist | 4 West Dr Ste 170, Chesterfield, MO 63017-1793 | 2019-12-12 |
| 1184130528 | Archway Oral Surgery and Dental Implants | Dentist | 16 Hampton Village Plz Ste 200, Saint Louis, MO 63109-2128 | 2017-12-21 |
| 1780120410 | Ervin Simmons Iv Dmd LLC | Dentist | 3220 Parker Rd, Florissant, MO 63033-3733 | 2017-01-19 |
| 1437531209 | Federico Castillo Iv | Dentist | 2521 Cherry St, Kansas City, MO 64108-2750 | 2015-06-29 |
| 1437579208 | Gregory Lohr | Dentist | 2931 Ne Independence Ave, Lees Summit, MO 64064 | 2014-04-21 |
| 1114347861 | Zachary L Brown | Dentist | 4700 Belleview Ave Ste L10, Kansas City, MO 64112-1360 | 2014-04-21 |
| 1265868863 | Gregory Pernoud | Dentist | 1204 E State Route 72, Rolla, MO 65401-3938 | 2013-09-16 |
| 1942551247 | Kansas City Surgical Arts LLC | Dentist | 8080 North Flintlock Road, Kansas City, MO 64158 | 2012-09-26 |
| Find all providers with the same taxonomy | ||||
| City | CREVE COEUR |
| Zip Code | 63141 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.