Oluwagbenga Serrano
Oluwagbenga Serrano is a healthcare organization registered as Gastroenterology Physician in Lakeside, AZ, holding Type 2 (organization) NPI 1104978600 since 2007. The authorized official on file is Oluwagbenga Serrano, Owner.
✓ Active NPI ✓ Valid NPI checksum
| NPI | 1104978600 |
|---|---|
| Entity type | Organization (Type 2) |
| Legal business name | Oluwagbenga Serrano |
| Other name | <Unavail> |
| Practice address | 218 W WHITE MOUNTAIN BLVD, SUITE C, Lakeside, AZ, 85929 |
| Phone | 9283673637 |
| Fax | 9283673638 |
| Enumeration date | 2007-01-17 |
| Last updated in NPPES | 2012-01-13 |
Authorized official
| Name | Oluwagbenga Serrano |
|---|---|
| Title | Owner |
| Phone | 9283673637 |
Taxonomy & classification
| Taxonomy code | Specialty | Primary | License | State |
|---|---|---|---|---|
| 207RG0100X | Gastroenterology Physician | Primary | 29877 | AZ |
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 025539 | Medicaid | AZ | — |
Copy-ready billing details
Provider: Oluwagbenga Serrano NPI: 1104978600 Taxonomy: 207RG0100X (Gastroenterology Physician) Address: 218 W WHITE MOUNTAIN BLVD, SUITE C, Lakeside, AZ, 85929
Providers at this address
| NPI | Name | Type | Specialty | Location |
|---|---|---|---|---|
| 1043249220 | Lorna Reisner | Individual | Nurse Practitioner | Lakeside, AZ |
| 1972706786 | Mustang Chiropractic, LLC | Organization | Chiropractor | Lakeside, AZ |
| 1699956235 | Peace Family Medicine PC | Organization | Family Medicine Physician | Lakeside, AZ |
| 1720213721 | Ed D Lauritsen Phd PC | Organization | Clinical Psychologist | Lakeside, AZ |
| 1528487840 | Jesse Wilcock | Individual | Occupational Therapist | Lakeside, AZ |
Verify this record
Cross-check NPI 1104978600 against the authoritative CMS record: view Oluwagbenga Serrano on the official NPPES registry .
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes — even if the provider moves or changes specialty. Read the full guide or validate an NPI number.
Frequently asked questions
What is the NPI number for Oluwagbenga Serrano?
Who is the authorized official for Oluwagbenga Serrano?
Source: CMS NPPES (public data). Snapshot 2026-07-11. Provider record last updated 2012-01-13.