Provider Demographics
NPI:1093437121
Name:SIGMA DENTAL LLC
Entity Type:Organization
Organization Name:SIGMA DENTAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:OLUWOLE
Authorized Official - Middle Name:OLUBUNMI
Authorized Official - Last Name:FADAHUNSI
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:267-499-0782
Mailing Address - Street 1:3305 CASTLE RIDGE CIR
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20904-7343
Mailing Address - Country:US
Mailing Address - Phone:267-499-0782
Mailing Address - Fax:
Practice Address - Street 1:1220 E JOPPA RD STE 314
Practice Address - Street 2:
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21286-5811
Practice Address - Country:US
Practice Address - Phone:410-583-7600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-15
Last Update Date:2022-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty