Provider Demographics
NPI:1083767602
Name:HUGHSON-OTTE, VIRGINIA A (DDS)
Entity Type:Individual
Prefix:DR
First Name:VIRGINIA
Middle Name:A
Last Name:HUGHSON-OTTE
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 1:27450 TOURNEY RD
Mailing Address - Street 2:SUITE 220
Mailing Address - City:VALENCIA
Mailing Address - State:CA
Mailing Address - Zip Code:91355-1828
Mailing Address - Country:US
Mailing Address - Phone:661-288-1555
Mailing Address - Fax:661-288-1661
Practice Address - Street 1:27450 TOURNEY RD
Practice Address - Street 2:SUITE 220
Practice Address - City:VALENCIA
Practice Address - State:CA
Practice Address - Zip Code:91355-1828
Practice Address - Country:US
Practice Address - Phone:661-288-1555
Practice Address - Fax:661-288-1661
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-18
Last Update Date:2008-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA374271223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice