Provider Demographics
NPI:1881744415
Name:ONYANGO, OMARI (DDS)
Entity type:Individual
Prefix:DR
First Name:OMARI
Middle Name:
Last Name:ONYANGO
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 1:14429 DALTON CT
Mailing Address - Street 2:
Mailing Address - City:VICTORVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:92394-3213
Mailing Address - Country:US
Mailing Address - Phone:760-245-5515
Mailing Address - Fax:760-245-5515
Practice Address - Street 1:12384 PALMDALE RD
Practice Address - Street 2:SUITE 204
Practice Address - City:VICTORVILLE
Practice Address - State:CA
Practice Address - Zip Code:92392-8506
Practice Address - Country:US
Practice Address - Phone:760-843-5400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-12
Last Update Date:2015-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA541831223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice