Provider Demographics
NPI:1295402600
Name:OKWUOSA, BRIDGET UCHENNA (DDS)
Entity Type:Individual
Prefix:DR
First Name:BRIDGET
Middle Name:UCHENNA
Last Name:OKWUOSA
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 1:5731 E SANTA ANA CANYON RD STE A
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92807-3234
Mailing Address - Country:US
Mailing Address - Phone:714-998-2956
Mailing Address - Fax:
Practice Address - Street 1:5731 E SANTA ANA CANYON RD STE A
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92807-3234
Practice Address - Country:US
Practice Address - Phone:714-998-2956
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-24
Last Update Date:2021-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA106699122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist