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General NPI Number Information
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NPI Number | 1417346909
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Entity Type | Individual
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Provider Name | JESUTOMI OJELEYE D.D.S.
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Gender | Female
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Dates
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Enumeration Date | 01/21/2015
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Last Update Date | 08/28/2025
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Provider Practice Location Address
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Address Line | 13705 W MAPLE ST
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City | WICHITA
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State | KS
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Zip | 67235-8701
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Country | US
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Telephone | 316-201-6323
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Fax |
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Provider Business Mailing Address
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Address Line | 3550 N TYLER CT
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City | WICHITA
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State | KS
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Zip | 67205-6407
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Country | US
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Telephone | 785-248-1933
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 019.29873
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 2015029032
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License Number State | MO
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Taxonomy #3
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 62259
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License Number State | KS
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