MEDICARE: CHIAKOWSKY JEGEDE DENTAL PARTNERSHIP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry

General Provider Information

NPI Number	:	1215883749
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHIAKOWSKY JEGEDE DENTAL PARTNERSHIP

Provider Business Mailing Address
First Line	:	11354 MOUNTAIN VIEW AVE STE B
Second Line	:
City	:	LOMA LINDA
State	:	CA
Zip	:	92354-3855
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	11354 MOUNTAIN VIEW AVE STE B
Second Line	:
City	:	LOMA LINDA
State	:	CA
Zip	:	92354-3855
Country	:	US
Telephone Number	:	909-796-5199
Fax Number	:

Authorized Official
Title or Position	:	DENTIST
Name	:	AKINLOLU JEGEDE
Credential	:
Telephone Number	:	909-796-5199

Provider Enumeration Date	:	03/06/2026
Last Update Date	:	03/10/2026

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