Healthcare Provider Details

I. General information

NPI: 1780675157
Provider Name (Legal Business Name): BARBARA OKAMOTO-SUBJECT D.D.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 11/03/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6134 CALLE REAL SUITE D
GOLETA CA
93117-2066
US

IV. Provider business mailing address

6134 CALLE REAL
GOLETA CA
93117-2067
US

V. Phone/Fax

Practice location:
  • Phone: 805-964-2211
  • Fax:
Mailing address:
  • Phone: 805-964-2211
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number32886
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License NumberDT1326
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: