Healthcare Provider Details

I. General information

NPI: 1225885775
Provider Name (Legal Business Name): ANNA RIE OGATA DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/02/2024
Last Update Date: 05/02/2024
Certification Date: 05/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13332 SOUTH ST
CERRITOS CA
90703-7309
US

IV. Provider business mailing address

13332 SOUTH ST
CERRITOS CA
90703-7309
US

V. Phone/Fax

Practice location:
  • Phone: 562-924-8342
  • Fax: 562-924-9232
Mailing address:
  • Phone: 562-924-8342
  • Fax: 562-924-9232

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number109572
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: