Provider Demographics
NPI:1568727576
Name:ADEGUN, OREOLUWA ANUOLUWAPO (DDS)
Entity Type:Individual
Prefix:
First Name:OREOLUWA
Middle Name:ANUOLUWAPO
Last Name:ADEGUN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:176 GULF FWY S
Mailing Address - Street 2:
Mailing Address - City:LEAGUE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77573-3792
Mailing Address - Country:US
Mailing Address - Phone:832-632-8811
Mailing Address - Fax:
Practice Address - Street 1:176 GULF FWY S
Practice Address - Street 2:
Practice Address - City:LEAGUE CITY
Practice Address - State:TX
Practice Address - Zip Code:77573-3792
Practice Address - Country:US
Practice Address - Phone:832-632-8811
Practice Address - Fax:832-632-4131
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-06
Last Update Date:2023-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX27986122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist