Healthcare Provider Details

I. General information

NPI: 1740457829
Provider Name (Legal Business Name): MICHAEL MAKOTO OKUJI DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/08/2008
Last Update Date: 05/08/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

490 POST ST SUITE 1550
SAN FRANCISCO CA
94102-1401
US

IV. Provider business mailing address

490 POST ST SUITE 1550
SAN FRANCISCO CA
94102-1401
US

V. Phone/Fax

Practice location:
  • Phone: 415-433-7810
  • Fax: 415-433-7815
Mailing address:
  • Phone: 415-433-7810
  • Fax: 415-433-7815

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number23548
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: