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NPI Code Detail

MEDICARE: DR. OLUBUNMI OLUSADA DDS

MEDICARE: DR. OLUBUNMI OLUSADA 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
11223G0001XGeneral Practice Dentistry0401416258VA
21223G0001XGeneral Practice Dentistry51157NC
31223G0001XGeneral Practice DentistryDEN2001595DC

Other Identifiers

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

General Provider Information

NPI Number : 1932621224
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. OLUBUNMI OLUSADA DDS
Provider Business Mailing Address
First Line : 4390 KING ST APT 505
Second Line :
City : ALEXANDRIA
State : VA
Zip : 22302-1542
Country : US
Telephone Number : 703-403-3701
Fax Number :
Provider Business Practice Location Address
First Line : 6428 GEORGIA AVE NW
Second Line :
City : WASHINGTON
State : DC
Zip : 20012-2910
Country : US
Telephone Number : 202-723-0303
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/09/2017
Last Update Date : 12/03/2025

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