IndividualActive
Blair Ota, DDS, MD
NPI 1366516023 · Oral and Maxillofacial Pathology Dentistry · Irvine, CA
Provider details
- NPI number
- 1366516023
- Entity type
- Individual
- Primary specialty
- Oral and Maxillofacial Pathology DentistryDental Providers
- Credential
- DDS, MD
- Sex
- Male
- Sole proprietor
- Yes
- License
- 24159 (CA)
Specialties & taxonomies
Dental Providers
Practice location
4980 Barranca Pkwy Ste 190
Irvine, CA 92604-8652
Phone: (949) 453-9797
Fax: (949) 872-2468
Approximate (ZIP-level) locationGet directions
Mailing address
4980 Barranca Pkwy Ste 190
Irvine, CA 92604-8652
Registry dates
- Enumerated
- 2006-11-17
- Last updated
- 2007-07-09
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.