Provider Demographics
NPI:1053484204
Name:OKADA, LORNA L (DDS)
Entity Type:Individual
Prefix:DR
First Name:LORNA
Middle Name:L
Last Name:OKADA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3827 PANDA LN
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95117-2777
Mailing Address - Country:US
Mailing Address - Phone:408-226-2522
Mailing Address - Fax:
Practice Address - Street 1:7176 SANTA TERESA BLVD
Practice Address - Street 2:SUITE B-1
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95139-1351
Practice Address - Country:US
Practice Address - Phone:408-226-2522
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA489761223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice