Provider Demographics
NPI:1689394041
Name:OSINUSI, ADENIKE (DDS)
Entity Type:Individual
Prefix:DR
First Name:ADENIKE
Middle Name:
Last Name:OSINUSI
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 1:1242 HERKIMER ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11233-3208
Mailing Address - Country:US
Mailing Address - Phone:205-201-8886
Mailing Address - Fax:
Practice Address - Street 1:573 CRANBURY RD
Practice Address - Street 2:
Practice Address - City:EAST BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08816-4144
Practice Address - Country:US
Practice Address - Phone:732-613-1931
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-29
Last Update Date:2022-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI02927700122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist