{
"Npi": {
"NPI": "1427946813",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "OPEIFA",
"FirstName": "OLUWABAMIDELE",
"MiddleName": null,
"NamePrefix": "DR.",
"NameSuffix": null,
"Credential": "DDS",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "OPEIFA",
"OtherFirstName": "DELE",
"OtherMiddleName": null,
"OtherNamePrefix": "DR.",
"OtherNameSuffix": null,
"OtherCredential": "DDS",
"OtherLastNameTypeCode": "2",
"FirstLineMailingAddress": "674 BOULEVARD DE FRANCE",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "PARRIS ISLAND",
"MailingAddressStateName": "SC",
"MailingAddressPostalCode": "29905",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": null,
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "MCRD PARRIS ISLAND DENTAL",
"SecondLinePracticeLocationAddress": "BLDG 674 BLVD DE FRANCE",
"PracticeLocationAddressCityName": "PARRIS ISLAND",
"PracticeLocationAddressStateName": "SC",
"PracticeLocationAddressPostalCode": "29905",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "843-228-5994",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "06/25/2025",
"LastUpdateDate": "06/25/2025",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "M",
"Gender": "Male",
"AuthorizedOfficialLastName": null,
"AuthorizedOfficialFirstName": null,
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": null,
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "122300000X",
"TaxonomyName": "Dentist",
"LicenseNumber": "14224617-9926",
"LicenseNumberStateCode": "UT",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}