Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Dr. Ebosetale Odiaogbe Okoruwa, DDS

Individual provider Dentist · NPI 1417444332

Dr. Ebosetale Odiaogbe Okoruwa, DDS is a Dentist in Cottage Grove, Minnesota. Licensed in Minnesota and Wisconsin. Registered with an NPI since 2018.

Licensed in
MN, WI
In the registry since
2018
Specialties on file
3
What do these letters mean?
DDS — Doctor of Dental Surgery
A dentist. DDS and DMD are the same qualification — universities choose which title to award.

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Practice location Address checks out

6936 Pine Arbor Dr S Ste 230
Cottage Grove, MN 55016-4645
Phone: (651) 204-5257
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dentist (primary) Taxonomy 122300000X · Licence D14478 (MN)
Dentist Taxonomy 122300000X · Licence 1002470 (WI)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1417444332
Entity typeIndividual (Type 1)
GenderMale
Credentials DDS
Sole proprietorNo
NPI enumeratedApril 16, 2018
Last updated in NPPESFebruary 12, 2024
Certification dateFebruary 12, 2024

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