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General NPI Number Information
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NPI Number | 1932267390
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Entity Type | Individual
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Provider Name | ANTHONY OLATUNJI D.M.D
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Gender | Male
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Dates
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Enumeration Date | 12/05/2006
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Last Update Date | 12/23/2025
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Provider Practice Location Address
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Address Line | 11900 AVALON BLVD STE 101
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City | LOS ANGELES
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State | CA
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Zip | 90061-2867
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Country | US
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Telephone | 310-331-8134
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Fax | 310-747-5273
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Provider Business Mailing Address
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Address Line | 1510 W ARTESIA SQ APT C
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City | GARDENA
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State | CA
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Zip | 90248-4768
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Country | US
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Telephone | 781-774-9885
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Fax | 310-747-5273
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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 | 19621
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 109702
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License Number State | CA
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