MEDICARE: DR. YETUNDE O ADEDEJI 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	DN25821	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1871166322
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. YETUNDE O ADEDEJI DDS

Provider Business Mailing Address
First Line	:	37944 PASCO AVE
Second Line	:
City	:	DADE CITY
State	:	FL
Zip	:	33525-4202
Country	:	US
Telephone Number	:	352-518-2000
Fax Number	:

Provider Business Practice Location Address
First Line	:	37912 CHURCH AVE
Second Line	:
City	:	DADE CITY
State	:	FL
Zip	:	33525-4207
Country	:	US
Telephone Number	:	352-518-2000
Fax Number	:

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

Provider Enumeration Date	:	07/22/2021
Last Update Date	:	08/19/2021

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Directions to “ DR. YETUNDE O ADEDEJI DDS” Practice Location

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