Provider Demographics
NPI:1477265320
Name:ABIMBOLA, TOYIN ADESEYE (DDS)
Entity Type:Individual
Prefix:DR
First Name:TOYIN
Middle Name:ADESEYE
Last Name:ABIMBOLA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:TOYIN
Other - Middle Name:ADESEYE
Other - Last Name:OLANREWAJU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:1189 RUSSET LN
Mailing Address - Street 2:
Mailing Address - City:APEX
Mailing Address - State:NC
Mailing Address - Zip Code:27523-8517
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1189 RUSSET LN
Practice Address - Street 2:
Practice Address - City:APEX
Practice Address - State:NC
Practice Address - Zip Code:27523-8517
Practice Address - Country:US
Practice Address - Phone:402-417-4244
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-21
Last Update Date:2023-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC131141223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice