Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | 5407 | DC |
N | 1223P0221X | Pediatric Dentist | 5407 | DC |
NPI | 1043379951 |
---|---|
Provider Name | Dr. Josephine Olunike Oguntimein |
First Address | Washington, DC 20011-4410 |
Second Address | Washington, DC 20011-4410 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/12/2006 |
Last Update Date | 08/01/2021 |