Provider Demographics
NPI:1447225081
Name:OZAKI, SCOTT T (DDS)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:T
Last Name:OZAKI
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 1:2452 FENTON ST
Mailing Address - Street 2:SUITE 302
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91914-3516
Mailing Address - Country:US
Mailing Address - Phone:619-482-3205
Mailing Address - Fax:619-482-3206
Practice Address - Street 1:2452 FENTON ST
Practice Address - Street 2:SUITE 302
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91914-3516
Practice Address - Country:US
Practice Address - Phone:619-482-3205
Practice Address - Fax:619-482-3206
Is Sole Proprietor?:No
Enumeration Date:2006-02-17
Last Update Date:2007-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA419771223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics