Healthcare Provider Details

I. General information

NPI: 1972414670
Provider Name (Legal Business Name): DORCAS OMOLOLA AYANLADUN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/14/2026
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2501 W 22ND ST
SIOUX FALLS SD
57105-1305
US

IV. Provider business mailing address

5703 S BOUNTY PL
SIOUX FALLS SD
57108-5178
US

V. Phone/Fax

Practice location:
  • Phone: 605-336-3230
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License NumberR054474
License Number StateSD
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberR054474
License Number StateSD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: