Provider Demographics
NPI:1780794818
Name:OVADIA, DARYL GENE (DDS)
Entity type:Individual
Prefix:DR
First Name:DARYL
Middle Name:GENE
Last Name:OVADIA
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 1:2533 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93003-2618
Mailing Address - Country:US
Mailing Address - Phone:805-643-0700
Mailing Address - Fax:805-643-6913
Practice Address - Street 1:2533 E MAIN ST
Practice Address - Street 2:
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003-2618
Practice Address - Country:US
Practice Address - Phone:805-643-0700
Practice Address - Fax:805-643-6913
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA313511223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice