Healthcare Provider Details

I. General information

NPI: 1225780927
Provider Name (Legal Business Name): GRANT OSHITA MD, DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/24/2022
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5589 WINFIELD BLVD
SAN JOSE CA
95123-1219
US

IV. Provider business mailing address

5589 WINFIELD BLVD
SAN JOSE CA
95123-1219
US

V. Phone/Fax

Practice location:
  • Phone: 408-265-9600
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number105881
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: