Provider Demographics
NPI:1063588986
Name:OYAMA, CLIFFORD K (DDS)
Entity type:Individual
Prefix:DR
First Name:CLIFFORD
Middle Name:K
Last Name:OYAMA
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 1:24225 CARY CT
Mailing Address - Street 2:
Mailing Address - City:NEWHALL
Mailing Address - State:CA
Mailing Address - Zip Code:91321-3925
Mailing Address - Country:US
Mailing Address - Phone:661-255-9579
Mailing Address - Fax:
Practice Address - Street 1:412 SAN FERNANDO MISSION BLVD
Practice Address - Street 2:
Practice Address - City:SAN FERNANDO
Practice Address - State:CA
Practice Address - Zip Code:91340-3530
Practice Address - Country:US
Practice Address - Phone:818-365-3934
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA24582122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist