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General NPI Number Information
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NPI Number | 1821953076
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Entity Type | Organization
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Legal Business Name | GARY U. OKAMOTO D.M.D. A PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 12/19/2025
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Last Update Date | 12/19/2025
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Provider Practice Location Address
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Address Line | 77564 COUNTRY CLUB DR STE 190A
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City | PALM DESERT
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State | CA
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Zip | 92211-0449
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Country | US
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Telephone | 760-360-0622
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Fax | 760-360-6282
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Provider Business Mailing Address
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Address Line | 77564 COUNTRY CLUB DR STE 190A
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City | PALM DESERT
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State | CA
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Zip | 92211-0449
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Country | US
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Telephone | 760-360-0622
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Fax | 760-360-6282
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Authorized Official
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Title or Position | DOCTOR / OWNER
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Name | DR. GARY U OKAMOTO
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Credential | DMD
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Telephone | 760-360-0622
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number |
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License Number State |
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