Provider Demographics
NPI:1871849125
Name:OSHITA, PATRICK SCOTT (DDS)
Entity Type:Individual
Prefix:
First Name:PATRICK
Middle Name:SCOTT
Last Name:OSHITA
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 1:437 N. 5TH STREET
Mailing Address - Street 2:
Mailing Address - City:MONTEBELLO
Mailing Address - State:CA
Mailing Address - Zip Code:90640-4203
Mailing Address - Country:US
Mailing Address - Phone:323-724-9200
Mailing Address - Fax:323-724-9057
Practice Address - Street 1:437 N. 5TH STREET
Practice Address - Street 2:
Practice Address - City:MONTEBELLO
Practice Address - State:CA
Practice Address - Zip Code:90640-4203
Practice Address - Country:US
Practice Address - Phone:323-724-9200
Practice Address - Fax:323-724-9057
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-24
Last Update Date:2012-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA44348122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist