Provider Demographics
NPI:1013219260
Name:AYITEY-ADJIN, JOSEPH O JR (DMD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:O
Last Name:AYITEY-ADJIN
Suffix:JR
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14836 IRELAND LN
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75035-1216
Mailing Address - Country:US
Mailing Address - Phone:214-783-4318
Mailing Address - Fax:
Practice Address - Street 1:761 S MACARTHUR BLVD
Practice Address - Street 2:SUITE 117
Practice Address - City:COPPELL
Practice Address - State:TX
Practice Address - Zip Code:75019-4227
Practice Address - Country:US
Practice Address - Phone:972-393-9700
Practice Address - Fax:972-745-8842
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-20
Last Update Date:2015-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX260351223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice