Oluwadara, Oluwadayo O

Oluwadara, Oluwadayo O is an individual health care provider with primary practice located at 9612 Foothill Blvd Ste 100 , Rancho Cucamonga CA 91730-3594. He recently has 2 registered licenses in different health care specialties including Dental Providers / General Practice, Dental Providers / Dentist. Dental Providers / General Practice is his primary health care specialty. Oluwadara, Oluwadayo O can be contacted via phone (909) 939-5569.

Contact Information

Primary practice address
9612 Foothill Blvd Ste 100 Rancho Cucamonga CA 91730-3594
Phone: (909) 939-5569
Fax: (909) 354-3230
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 27453 Texas
Dental Providers / General Practice 1223G0001X 101235 California
Dental Providers / Dentist 122300000X 6775-15 Wisconsin

Profile Details

NPI number 1184911240
LBN Legal business name Oluwadara, Oluwadayo O
Credentials MS, PHD, DDS
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 8th, 2011
Last updated Oct 14th, 2022 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1184911240 NPPES
Texas MEDICAID 284941617

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