Doctor profile · Federal record

Dr. Ebosetale Okoruwa, DDS

Dentist · Dentist · Student in an Organized Health Care Education/Training Program · Cottage Grove, MN

  • NPI 1417444332
  • 8 yrs on file
  • Licensed in 2 states
  • Male
  • Group practice
  • No sanctions

Practice & contact

NPPES Updated May 11, 2026
Primary practice
6936 Pine Arbor Dr S Ste 230
Cottage Grove, MN 550164645
(651) 204-5257
Mailing address
2052 Irene St
Roseville, MN 551136613

Credentials & registration

NPPES · NUCC
NPI registered
April 2018 — 8 yrs on file
Profile last updated
February 12, 2024
Specialty taxonomy
122300000X — NUCC code
State licenses (2)
Minnesota #D14478 · Wisconsin #1002470

Federal sanctions & exclusions

OIG LEIE Updated May 11, 2026

No sanctions, exclusions or revocations on file

Checked against OIG LEIE on NPI 1417444332. Last verified May 11, 2026.

Open Payments

Industry payments received

CMS Open Payments
All-time total
$415
Transactions
12
Manufacturers
3
Payer (manufacturer) Industry Txns Amount
Hu-Friedy Mfg. Co., LLC 10 $385.92
Gc America INC. 1 $15.89
Ultradent Products INC 1 $13.09

By nature of payment

Education
$386
Food and Beverage
$29

Frequently asked questions

Auto-generated from federal data
What is Dr. Ebosetale Okoruwa's medical specialty?
Dr. Ebosetale Okoruwa practices Dentist in Cottage Grove, MN.
Where does Dr. Ebosetale Okoruwa practice?
Dr. Ebosetale Okoruwa practices at 6936 Pine Arbor Dr S Ste 230, Cottage Grove, MN 550164645. Office phone: 6512045257.
What is Dr. Ebosetale Okoruwa's NPI?
Dr. Ebosetale Okoruwa's National Provider Identifier (NPI) is 1417444332, issued by NPPES.