Healthcare Provider Details

I. General information

NPI: 1003034943
Provider Name (Legal Business Name): STEVEN D OGAZ DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/24/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4122 E CHAPMAN AVE STE 1
ORANGE CA
92869-4053
US

IV. Provider business mailing address

4122 E CHAPMAN AVE STE 1
ORANGE CA
92869-4053
US

V. Phone/Fax

Practice location:
  • Phone: 714-639-9171
  • Fax: 714-639-2096
Mailing address:
  • Phone: 714-639-9171
  • Fax: 714-639-2096

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number24397
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: