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NPI Code Detail

MEDICARE: TOBI ODEJIMI DDS

MEDICARE: TOBI ODEJIMI DDS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training Program
2122300000XDentist35950TX

General Provider Information

NPI Number : 1578122701
Entity Type Code : Individual
Provider Name (Legal Business Name) : TOBI ODEJIMI DDS
Provider Business Mailing Address
First Line : 9205 EAGLE DR STE 100
Second Line :
City : MONT BELVIEU
State : TX
Zip : 77523-5620
Country : US
Telephone Number : 281-241-4249
Fax Number :
Provider Business Practice Location Address
First Line : 9205 EAGLE DR STE 100
Second Line :
City : MONT BELVIEU
State : TX
Zip : 77523-5620
Country : US
Telephone Number : 281-241-4249
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/11/2019
Last Update Date : 08/18/2020

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Directions to “ TOBI ODEJIMI DDS” Practice Location

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