Provider Demographics
NPI:1134327406
Name:OGUNBEKUN, ADENIKE (DDS, MSC)
Entity Type:Individual
Prefix:DR
First Name:ADENIKE
Middle Name:
Last Name:OGUNBEKUN
Suffix:
Gender:F
Credentials:DDS, MSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12697 VICTORY LAKES LOOP
Mailing Address - Street 2:
Mailing Address - City:BRISTOW
Mailing Address - State:VA
Mailing Address - Zip Code:20136-1274
Mailing Address - Country:US
Mailing Address - Phone:585-530-7402
Mailing Address - Fax:
Practice Address - Street 1:9822 LIBERIA AVE
Practice Address - Street 2:
Practice Address - City:MANASSAS
Practice Address - State:VA
Practice Address - Zip Code:20110-5836
Practice Address - Country:US
Practice Address - Phone:703-980-5981
Practice Address - Fax:703-496-5359
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-06
Last Update Date:2016-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014132251223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice