Provider Demographics
NPI:1669202594
Name:AKEJU, OLAJIDE TOLULOPE (DMD)
Entity type:Individual
Prefix:DR
First Name:OLAJIDE
Middle Name:TOLULOPE
Last Name:AKEJU
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2402 WOODED PARK DR
Mailing Address - Street 2:
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77459-1537
Mailing Address - Country:US
Mailing Address - Phone:403-891-8133
Mailing Address - Fax:
Practice Address - Street 1:11455 CANAL XING
Practice Address - Street 2:
Practice Address - City:BRUNSWICK
Practice Address - State:GA
Practice Address - Zip Code:31525-6747
Practice Address - Country:US
Practice Address - Phone:912-217-4953
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-05
Last Update Date:2024-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
GADN123578122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program