Provider Demographics
NPI:1164083069
Name:OKUMU, BERNARD SANYA (DDS)
Entity Type:Individual
Prefix:DR
First Name:BERNARD
Middle Name:SANYA
Last Name:OKUMU
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7504 CONTINENTAL PKWY
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79119-6376
Mailing Address - Country:US
Mailing Address - Phone:806-443-8005
Mailing Address - Fax:
Practice Address - Street 1:1301 E US HIGHWAY 83
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78501-8818
Practice Address - Country:US
Practice Address - Phone:965-994-0349
Practice Address - Fax:965-994-0988
Is Sole Proprietor?:No
Enumeration Date:2019-06-22
Last Update Date:2019-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX353881223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice