Healthcare Provider Details

I. General information

NPI: 1801705843
Provider Name (Legal Business Name): OLUWATOBI ADEDOYIN TITILOYE DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/04/2026
Last Update Date: 09/04/2026
Certification Date: 09/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 ASPEN DR APT 16
CLARION IA
50525-1022
US

IV. Provider business mailing address

105 ASPEN DR APT 16
CLARION IA
50525-1022
US

V. Phone/Fax

Practice location:
  • Phone: 515-576-6500
  • Fax: 515-576-1951
Mailing address:
  • Phone: 515-576-6500
  • Fax: 515-576-1951

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number10553
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: