OLUTAYO A. ODUSANWO DMD - NPI 1821492505 - Dentist in Providence, RI

Q: What is Olutayo Odusanwo's NPI number?

The NPI number for Olutayo Odusanwo is 1821492505. It was assigned to this individual provider in the NPPES registry on October 9, 2014.

Q: What is Olutayo Odusanwo's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Pediatric Dentistry, with taxonomy code 1223P0221X.

Q: When was this NPI record last updated?

The NPPES record for Olutayo Odusanwo was last updated on July 23, 2019. NPI Profile syncs with the weekly NPPES data releases published by CMS.

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About Olutayo A. Odusanwo Dmd NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

OLUTAYO A. ODUSANWO DMD (NPI 1821492505) is an individual pediatric dentistry provider in Providence, Rhode Island, licensed in Rhode Island (DEN03469) and active in the NPI registry since October 2014. She is enrolled in Medicare PECOS and maintains a secondary practice location in Providence.

NPPES Registry Identity

NPI1821492505

Entity TypeIndividualFemale

Primary Taxonomy1223P0221X

Provider Legal NameOLUTAYO A. ODUSANWOCredential: DMD

Location Address335 PRAIRIE AVEProvidence, RI 02905

Mailing Address375 Allens AveProvidence, RI 02905-5010 · (401) 444-0400 · Fax (401) 444-0468

Phone(401) 444-0430

Fax(401) 444-0489

Sole ProprietorNo

Enumeration DateOctober 9, 2014

Last NPPES UpdateJuly 23, 20193 updates tracked since enumeration

✔ NPI 1821492505 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyDentist · Pediatric DentistryDental Providers

Taxonomy Code1223P0221X

License✔ Licensed in RI · DEN03469

Definition

An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.

Also ListedDentistTaxonomy 122300000X · License DN1856580 (MA)

335 PRAIRIE AVE, Providence, RI 02905

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Secondary Practice Location 1

Location 1335 Prairie AveProvidence, RI 02905 · Phone (401) 444-0430 · Fax (401) 444-0489

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Sheld, Anthem Blue Cross and Blue Shield, BEST Life and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Olutayo A. Odusanwo Dmd is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 02905 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$90.48 typical visit price

range $58.57 – $177.03

Typical copayment $22.62 (range $14.64 – $44.25)

Most-billed visit code 99203

Established Patient

$72.93 typical visit price

range $18.92 – $144.38

Typical copayment $18.23 (range $4.73 – $36.09)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 13

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

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