Provider Demographics
NPI:1407049570
Name:STEVEN M OTANI DDS AND ROBERT A OTANI DDS
Entity Type:Organization
Organization Name:STEVEN M OTANI DDS AND ROBERT A OTANI DDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:M
Authorized Official - Last Name:OTANI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:916-428-7903
Mailing Address - Street 1:1355 FLORIN RD
Mailing Address - Street 2:STE 7
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95822
Mailing Address - Country:US
Mailing Address - Phone:916-428-7903
Mailing Address - Fax:916-428-7903
Practice Address - Street 1:1355 FLORIN RD
Practice Address - Street 2:STE 7
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95822
Practice Address - Country:US
Practice Address - Phone:916-428-7903
Practice Address - Fax:916-428-7903
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-22
Last Update Date:2007-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA34538122300000X
CA37472122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty