Individual provider · Type 1 NPI
Amanda Jo Okundaye, DDS
Dental Anesthesiology · Los Angeles, CA
Practice location
11970 Montana Ave Apt 208
Los Angeles, CA 90049-5043
Fax (424) 208-3232
Mailing address
3815 Tropical Vine St
Las Vegas, NV 89147-8079
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dentist | 122300000X | 56779 (CA) |
| Dental Anesthesiology | 1223D0004X | 56779 (CA) |
| Dental Anesthesiology Primary | 1223D0004X | 5993 (NV) |
Dental Anesthesiology: A dentist who has successfully completed an accredited postdoctoral anesthesiology residency training program for dentists of two or more years duration, in accord with Commission on Dental Accreditation's Standards for Dental Anesthesiology Residency Programs, and/or meets the eligibility requirements for examination by the American Dental Board of Anesthesiology.
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About NPI 1700044781
Amanda Jo Okundaye, DDS's National Provider Identifier is 1700044781, issued on May 27, 2008. The primary taxonomy on file is Dental Anesthesiology (1223D0004X), and the practice location is in Los Angeles, CA. The record was last updated on May 20, 2013.