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General NPI Number Information
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NPI Number | 1306530191
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Entity Type | Individual
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Provider Name | OMOWUNMI ONI DMD
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Gender | Female
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Dates
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Enumeration Date | 06/06/2023
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Last Update Date | 07/17/2025
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Provider Practice Location Address
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Address Line | 2101 BAKER CARTER DR # 200
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City | LOGANVILLE
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State | GA
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Zip | 30052-7466
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Country | US
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Telephone | 678-783-6400
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Fax |
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Provider Business Mailing Address
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Address Line | 1372 ARLENE VALLEY LN
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City | LAWRENCEVILLE
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State | GA
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Zip | 30043-3098
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DN123700
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | DN123700
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License Number State | GA
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