Provider Demographics
NPI:1679657159
Name:OKAM, ADORA ANNE (DDS)
Entity Type:Individual
Prefix:
First Name:ADORA
Middle Name:ANNE
Last Name:OKAM
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 1:27150 CHERRY LAUREL PL
Mailing Address - Street 2:
Mailing Address - City:CANYON COUNTRY
Mailing Address - State:CA
Mailing Address - Zip Code:91387-3819
Mailing Address - Country:US
Mailing Address - Phone:661-373-7175
Mailing Address - Fax:
Practice Address - Street 1:1228 W AVENUE K
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93534-5922
Practice Address - Country:US
Practice Address - Phone:661-949-1970
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA509641223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice