Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223S0112X | Oral and Maxillofacial Surgeon | DEN5606 | DC |
N | 204E00000X | Oral & Maxillofacial Surgeon | DEN5606 | DC |
NPI | 1477672053 |
---|---|
Provider Name | Dr. Temidayo Adebimpe Obayomi |
First Address | Washington, DC 20060-0001 |
Second Address | Washington, DC 20060-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/03/2007 |
Last Update Date | 03/01/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
039176800 | (05) | DC |
047870500 | (05) | DC |