Healthcare Provider Details

I. General information

NPI: 1770375008
Provider Name (Legal Business Name): BIODOT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/21/2025
Last Update Date: 05/21/2025
Certification Date: 05/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5617 CRESCENT RIDGE DR
WHITE MARSH MD
21162-1148
US

IV. Provider business mailing address

5617 CRESCENT RIDGE DR
WHITE MARSH MD
21162-1148
US

V. Phone/Fax

Practice location:
  • Phone: 667-942-1837
  • Fax:
Mailing address:
  • Phone: 667-942-1837
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: ABIOLA OYINADE DADA
Title or Position: CO-OWNER
Credential: DNP
Phone: 667-942-1837