DR. ADEPITAN OWOSHO (DDS) – Oral and Maxillofacial Pathology Dentistry, NPI 1104302264
Oral and Maxillofacial Pathology Dentistry
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for DR. ADEPITAN OWOSHO (DDS)
1500 PARK AVE
SAINT LOUIS, MO 631043024
Phone: (314) 833-2729
Type: Mailing
Kirksville College of Osteopathic Medicine, 800, West Jefferson Street, Kirksville, Adair County, Missouri, 63501, United States
KIRKSVILLE, MO 635011443
Phone: (660) 626-2843
Type: Mailing
5701 Delmar Blvd
Saint Louis, MO 631122617
Phone: (314) 367-7848
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2025-04-08
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20250408000904 | I | Dentist | MO | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 63104)
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