Healthcare Provider Details

I. General information

NPI: 1558489856
Provider Name (Legal Business Name): DR. KENT OCHIAI
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/26/2007
Last Update Date: 11/05/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1601 N BRISTOL ST
SANTA ANA CA
92706-3315
US

IV. Provider business mailing address

1601 N BRISTOL ST SUITE A
SANTA ANA CA
92706-3315
US

V. Phone/Fax

Practice location:
  • Phone: 714-542-9606
  • Fax: 714-542-7972
Mailing address:
  • Phone: 714-542-9606
  • Fax: 714-542-7972

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0700X
TaxonomyProsthodontics
License Number35436
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: