MEDICARE: DR. FRANCIS O BADEJOKO 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
1	122300000X	Dentist	DD5001	NM
2	1223G0001X	General Practice Dentistry	10645	CO
3	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	0401417359	VA

General Provider Information

NPI Number	:	1649545211
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. FRANCIS O BADEJOKO DDS

Provider Business Mailing Address
First Line	:	9928 E ALABAMA DR
Second Line	:	APARTMENT 1711
City	:	DENVER
State	:	CO
Zip	:	80247-6339
Country	:	US
Telephone Number	:	720-272-1351
Fax Number	:

Provider Business Practice Location Address
First Line	:	4239 HOLLAND RD STE 762A
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23452-1943
Country	:	US
Telephone Number	:	467-566-5757
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/15/2012
Last Update Date	:	04/07/2021

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