Provider Demographics
NPI:1154990307
Name:GBADAMOSI, OLUFUNKE OYINLOLA (DDS)
Entity type:Individual
Prefix:DR
First Name:OLUFUNKE
Middle Name:OYINLOLA
Last Name:GBADAMOSI
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 1:11271 NW 7TH ST APT 11
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33172-6505
Mailing Address - Country:US
Mailing Address - Phone:702-937-8337
Mailing Address - Fax:
Practice Address - Street 1:1133 AIRPORT BLVD
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32504-8607
Practice Address - Country:US
Practice Address - Phone:850-466-4133
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-22
Last Update Date:2021-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN260711223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice