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Active NPI 1992405385 Individual Practitioner Female Practitioner

Oluwafisayo Jebutu

Dentist - General Practice • Champaign, IL

Professional Overview & Biography Verified Profile Summary

Oluwafisayo Jebutu is a registered healthcare professional specializing in Dentist - General Practice in Champaign, IL. Practice services are available at 1902 N PROSPECT AVE STE 1 under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

1902 N Prospect Ave Ste 1

Champaign, IL 618221411

Telephone 2174082511
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Champaign, IL

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 18.0 Yrs
Regional Practice Density
46 Specialists

Practicing in Champaign, IL (5581 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2023-06-09
Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License IL 019034360

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

Student in an Organized Health Care Education/Training Program

NUCC Taxonomy Code: 390200000X

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

Secondary Practice Locations

3302 Gaston Ave

Dallas, TX 752462013

Phone: 2148288215

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

8 Historical Events
📍
Updated Practice Location June 09, 2023

Registered at 1902 N PROSPECT AVE STE 1, CHAMPAIGN, IL 618221411 (Tel: 2174082511)

📍
Updated Business Mailing Address June 09, 2023

Registered at 1902 N PROSPECT AVE STE 1, CHAMPAIGN, IL 618221411 (Tel: 2174082511)

NPI Profile Active March 06, 2023

NPI status registered as active in NPPES database

📍
Updated Practice Location March 06, 2023

Registered at 3302 GASTON AVE, DALLAS, TX 752462013 (Tel: 2148288215)

📍
Updated Business Mailing Address March 06, 2023

Registered at 3302 GASTON AVE, DALLAS, TX 752462013 (Tel: 2148288215)

👤
Provider Name / Credentials Updated March 06, 2023

Recorded as OLUWAFISAYO JEBUTU

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) March 06, 2023

Student in an Organized Health Care Education/Training Program

🟢
Initial NPI Registration & Enumeration March 06, 2023

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1992405385
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: March 06, 2023
Last Update: June 09, 2023
Sole Proprietor: No

Mailing Address

1902 N Prospect Ave Ste 1

Champaign, IL 618221411

Phone: 2174082511

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.