Healthcare Provider Details

I. General information

NPI: 1316398928
Provider Name (Legal Business Name): ADEDOLAPO ELIZABETH AYEDIRAN DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/24/2016
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2333 MORRIS AVE STE B109
UNION NJ
07083-5716
US

IV. Provider business mailing address

2333 MORRIS AVE STE B109
UNION NJ
07083-5716
US

V. Phone/Fax

Practice location:
  • Phone: 908-206-4700
  • Fax:
Mailing address:
  • Phone: 908-206-4700
  • Fax: 908-206-4701

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number22DI02809800
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: