Pamela Jean Ota, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

35439 Issued in CA

Practice address

1480 S. Harbor Blvd.
Suite 12
La Habra, CA 90631-7569

Phone

(714) 446-8841

Fax

(714) 446-8842

NPI assigned

May 17, 2007

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643587200000",
    "number": "1629285705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1480 S. HARBOR BLVD.,",
            "address_2": "SUITE 12",
            "city": "LA HABRA",
            "state": "CA",
            "postal_code": "906317569",
            "telephone_number": "714-446-8841",
            "fax_number": "714-446-8842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1480 S. HARBOR BLVD.",
            "address_2": "SUITE 12",
            "city": "LA HABRA",
            "state": "CA",
            "postal_code": "906317569",
            "telephone_number": "714-446-8841",
            "fax_number": "714-446-8842"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OTA",
        "first_name": "PAMELA",
        "middle_name": "JEAN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-17",
        "last_updated": "2022-01-31",
        "certification_date": "2022-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "35439",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "35439",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "HI",
            "license": "1523",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentist in La Habra, CA
• Providers in La Habra, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.