=====================================================
General NPI Number Information
=====================================================
NPI Number | 1215271804
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | OMOFOLAKE ABIKE DADA
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/20/2012
-----------------------------------------------------
Last Update Date | 12/22/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5802 ANNAPOLIS RD APT 711
-----------------------------------------------------
City | BLADENSBURG
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 20710-2017
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 301-765-4809
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5802 ANNAPOLIS RD APT 711
-----------------------------------------------------
City | BLADENSBURG
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 20710-2017
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 301-765-4809
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 374U00000X
-----------------------------------------------------
Taxonomy Name | Home Health Aide
-----------------------------------------------------
License Number | HHA5517
-----------------------------------------------------
License Number State | DC
-----------------------------------------------------