Provider Demographics
NPI:1821180118
Name:OKAZAKI, JEANETTE MIDORI (DDS)
Entity Type:Individual
Prefix:
First Name:JEANETTE
Middle Name:MIDORI
Last Name:OKAZAKI
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 1:2525 K STREET
Mailing Address - Street 2:#305
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95816
Mailing Address - Country:US
Mailing Address - Phone:916-329-3400
Mailing Address - Fax:
Practice Address - Street 1:2525 K ST
Practice Address - Street 2:#305
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95816-5114
Practice Address - Country:US
Practice Address - Phone:916-329-3400
Practice Address - Fax:916-329-3409
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2009-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA28370122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist