Dr. Abisola Jegede, DMD, MPH
Dentist, Orthodontics and Dentofacial Orthopedics in South Bend, IN. Individual provider (NPI-1).
NPI number1962029934
StatusActive
Last updated in NPPESAug 20, 2025
Details
- NPI
- 1962029934
- Entity type
- Individual (NPI-1)
- Name
- Dr. Abisola Jegede
- Credential
- DMD, MPH
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jun 25, 2020
- Certification date
- Aug 20, 2025
- Last updated
- Aug 20, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223X0400X | Dentist, Orthodontics and Dentofacial Orthopedics | 12014860A | IN | Yes |
| 122300000X | Dentist | 7109 | LA |
Practice location
919 E Jefferson Blvd Ste 100South Bend, IN 46617-3112
Phone 574-245-7504
Mailing address
3411 Nelson Rd Ste 100Lake Charles, LA 70605-1240
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Other Orthodontics and Dentofacial Orthopedics Dentistry providers in South Bend, IN
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- Steven C Wong, DDS, MSNPI 1588723100
All 6 Orthodontics and Dentofacial Orthopedics Dentistry providers in South Bend · All 3,973 providers in South Bend
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