Provider Demographics
NPI:1376730135
Name:DELANO, EMMANUEL OLUTAYO (BDS, MS)
Entity Type:Individual
Prefix:DR
First Name:EMMANUEL
Middle Name:OLUTAYO
Last Name:DELANO
Suffix:
Gender:M
Credentials:BDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 6073
Mailing Address - Street 2:
Mailing Address - City:CHRISTIANSTED
Mailing Address - State:VI
Mailing Address - Zip Code:00823-6073
Mailing Address - Country:US
Mailing Address - Phone:340-778-3636
Mailing Address - Fax:340-719-3865
Practice Address - Street 1:1CL & 1CP ESTATE DIAMOND
Practice Address - Street 2:
Practice Address - City:CHRISTIANSTED
Practice Address - State:VI
Practice Address - Zip Code:00820
Practice Address - Country:US
Practice Address - Phone:340-778-3636
Practice Address - Fax:340-719-3636
Is Sole Proprietor?:No
Enumeration Date:2007-09-26
Last Update Date:2007-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VI1221122300000X, 1223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223E0200XDental ProvidersDentistEndodontics