Provider Demographics
NPI:1295004760
Name:OSADA, NAOMI (DDS)
Entity Type:Individual
Prefix:MS
First Name:NAOMI
Middle Name:
Last Name:OSADA
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 1:3949 ARTESIA BLVD.
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90504
Mailing Address - Country:US
Mailing Address - Phone:310-878-0880
Mailing Address - Fax:310-220-0776
Practice Address - Street 1:3949 ARTESIA BLVD.
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90504
Practice Address - Country:US
Practice Address - Phone:310-878-0880
Practice Address - Fax:310-220-0776
Is Sole Proprietor?:No
Enumeration Date:2011-12-29
Last Update Date:2017-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX256431223G0001X
CA60097122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice