Provider Demographics
NPI:1164641536
Name:OCHOA, GERMAN ENRIQUE (DMD)
Entity Type:Individual
Prefix:DR
First Name:GERMAN
Middle Name:ENRIQUE
Last Name:OCHOA
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12311 TAFT ST STE 3
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33026-4384
Mailing Address - Country:US
Mailing Address - Phone:954-842-4604
Mailing Address - Fax:954-404-8189
Practice Address - Street 1:12311 TAFT ST STE 3
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33026-4384
Practice Address - Country:US
Practice Address - Phone:954-842-4604
Practice Address - Fax:954-404-8189
Is Sole Proprietor?:No
Enumeration Date:2007-04-24
Last Update Date:2020-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA53636122300000X
FL20287122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist