Provider Demographics
NPI:1912030420
Name:O'CALLAGHAN, PRIYA (DDS)
Entity Type:Individual
Prefix:DR
First Name:PRIYA
Middle Name:
Last Name:O'CALLAGHAN
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 1:6637 EXETER DR
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94611-1642
Mailing Address - Country:US
Mailing Address - Phone:510-451-6828
Mailing Address - Fax:510-499-9415
Practice Address - Street 1:1700 BROADWAY
Practice Address - Street 2:10TH FLOOR
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94612-2116
Practice Address - Country:US
Practice Address - Phone:510-451-6828
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCA458821223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics