Provider Demographics
NPI:1083955017
Name:OYAMA, RANDI (DDS)
Entity Type:Individual
Prefix:
First Name:RANDI
Middle Name:
Last Name:OYAMA
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 1:24225 CARY CT
Mailing Address - Street 2:
Mailing Address - City:NEWHALL
Mailing Address - State:CA
Mailing Address - Zip Code:91321-3925
Mailing Address - Country:US
Mailing Address - Phone:661-373-4897
Mailing Address - Fax:
Practice Address - Street 1:412 SAN FERNANDO MISSION BLVD
Practice Address - Street 2:
Practice Address - City:SAN FERNANDO
Practice Address - State:CA
Practice Address - Zip Code:91340-3530
Practice Address - Country:US
Practice Address - Phone:661-373-4897
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-15
Last Update Date:2014-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA63750122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist