Provider Demographics
NPI:1265654982
Name:OKADA, GEOFFREY TOSHIO (DDS, MS)
Entity type:Individual
Prefix:DR
First Name:GEOFFREY
Middle Name:TOSHIO
Last Name:OKADA
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2701 W ALAMEDA AVE
Mailing Address - Street 2:SUITE 405
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91505-4402
Mailing Address - Country:US
Mailing Address - Phone:818-843-0668
Mailing Address - Fax:818-843-0768
Practice Address - Street 1:2701 W ALAMEDA AVE
Practice Address - Street 2:SUITE 405
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91505-4402
Practice Address - Country:US
Practice Address - Phone:818-843-0668
Practice Address - Fax:818-843-0768
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA324331223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics