Provider Demographics
NPI:1942796479
Name:AWE, ADESEYE (DDS)
Entity Type:Individual
Prefix:DR
First Name:ADESEYE
Middle Name:
Last Name:AWE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5651 FRIST BLVD STE 300
Mailing Address - Street 2:
Mailing Address - City:HERMITAGE
Mailing Address - State:TN
Mailing Address - Zip Code:37076-2057
Mailing Address - Country:US
Mailing Address - Phone:615-889-7835
Mailing Address - Fax:615-889-7837
Practice Address - Street 1:5651 FRIST BLVD STE 300
Practice Address - Street 2:
Practice Address - City:HERMITAGE
Practice Address - State:TN
Practice Address - Zip Code:37076-2057
Practice Address - Country:US
Practice Address - Phone:615-889-7835
Practice Address - Fax:615-889-7837
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-09
Last Update Date:2024-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN109951223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery