Provider Demographics
NPI:1548680762
Name:OYE-SOMEFUN, YEWANDE O (DDS)
Entity type:Individual
Prefix:
First Name:YEWANDE
Middle Name:O
Last Name:OYE-SOMEFUN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:YEWANDE
Other - Middle Name:O
Other - Last Name:OYE-SOMEFUN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
Mailing Address - Street 1:160 MOVIE ROW
Mailing Address - Street 2:
Mailing Address - City:SMYRNA
Mailing Address - State:TN
Mailing Address - Zip Code:37167-6532
Mailing Address - Country:US
Mailing Address - Phone:615-930-9606
Mailing Address - Fax:
Practice Address - Street 1:440 SAM RIDLEY PKWY W
Practice Address - Street 2:
Practice Address - City:SMYRNA
Practice Address - State:TN
Practice Address - Zip Code:37167-2998
Practice Address - Country:US
Practice Address - Phone:615-930-9606
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-27
Last Update Date:2016-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN100241223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice