Healthcare Provider Details

I. General information

NPI: 1619722840
Provider Name (Legal Business Name): OLUWATOBI ELIZABETH DAUDA DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/22/2024
Last Update Date: 06/27/2025
Certification Date: 06/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7839 EASTPOINT MALL
BALTIMORE MD
21224-2116
US

IV. Provider business mailing address

44150 DUNHAM CT
CLINTON TOWNSHIP MI
48038-1521
US

V. Phone/Fax

Practice location:
  • Phone: 443-836-4776
  • Fax:
Mailing address:
  • Phone: 313-899-9257
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number18795
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: