MEDICARE: BARBARA OKAMOTO-SUBJECT D.D.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	32886	CA
2	122300000X	Dentist	DT1326	HI

General Provider Information

NPI Number	:	1780675157
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BARBARA OKAMOTO-SUBJECT D.D.S.

Provider Business Mailing Address
First Line	:	6134 CALLE REAL
Second Line	:
City	:	GOLETA
State	:	CA
Zip	:	93117-2067
Country	:	US
Telephone Number	:	805-964-2211
Fax Number	:

Provider Business Practice Location Address
First Line	:	6134 CALLE REAL
Second Line	:	SUITE D
City	:	GOLETA
State	:	CA
Zip	:	93117-2066
Country	:	US
Telephone Number	:	805-964-2211
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/03/2005
Last Update Date	:	07/08/2007

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