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General NPI Number Information
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NPI Number | 1881744415
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Entity Type | Individual
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Provider Name | OMARI ONYANGO DDS
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Gender | Male
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Dates
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Enumeration Date | 01/12/2007
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Last Update Date | 05/28/2015
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Provider Practice Location Address
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Address Line | 12384 PALMDALE RD SUITE 204
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City | VICTORVILLE
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State | CA
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Zip | 92392-8506
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Country | US
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Telephone | 760-843-5400
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Fax |
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Provider Business Mailing Address
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Address Line | 14429 DALTON CT
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City | VICTORVILLE
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State | CA
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Zip | 92394-3213
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Country | US
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Telephone | 760-245-5515
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Fax | 760-245-5515
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 54183
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License Number State | CA
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