Provider Demographics
NPI:1598884389
Name:OH, JASON J (DDS)
Entity Type:Individual
Prefix:
First Name:JASON
Middle Name:J
Last Name:OH
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 1:38427 20TH ST E
Mailing Address - Street 2:
Mailing Address - City:PALMDALE
Mailing Address - State:CA
Mailing Address - Zip Code:93550-4034
Mailing Address - Country:US
Mailing Address - Phone:661-273-3600
Mailing Address - Fax:661-273-3760
Practice Address - Street 1:38427 20TH ST E
Practice Address - Street 2:
Practice Address - City:PALMDALE
Practice Address - State:CA
Practice Address - Zip Code:93550-4034
Practice Address - Country:US
Practice Address - Phone:661-273-3600
Practice Address - Fax:661-273-3760
Is Sole Proprietor?:No
Enumeration Date:2007-03-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA530911223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice