Provider Demographics
NPI:1265182794
Name:OSAKUE, EVBU SHARON (DDS)
Entity type:Individual
Prefix:
First Name:EVBU
Middle Name:SHARON
Last Name:OSAKUE
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 1:1830 COMMERCIAL WAY
Mailing Address - Street 2:
Mailing Address - City:SANTA CRUZ
Mailing Address - State:CA
Mailing Address - Zip Code:95065-1819
Mailing Address - Country:US
Mailing Address - Phone:831-464-5409
Mailing Address - Fax:
Practice Address - Street 1:1830 COMMERCIAL WAY
Practice Address - Street 2:
Practice Address - City:SANTA CRUZ
Practice Address - State:CA
Practice Address - Zip Code:95065-1819
Practice Address - Country:US
Practice Address - Phone:831-464-5409
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-27
Last Update Date:2022-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program