1457339186 NPI number — SUNAHARA DENTAL, INC.

Table of content: (NPI 1457339186)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1457339186 NPI number — SUNAHARA DENTAL, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SUNAHARA DENTAL, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1457339186
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
66-230 KAMEHAMEHA HWY
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HALEIWA
Provider Business Mailing Address State Name:
HI
Provider Business Mailing Address Postal Code:
96712-1421
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
808-637-4550
Provider Business Mailing Address Fax Number:
808-637-4552

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
66-230 KAMEHAMEHA HWY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HALEIWA
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96712-1421
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-637-4550
Provider Business Practice Location Address Fax Number:
808-637-4552
Provider Enumeration Date:
01/03/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
SUNAHARA
Authorized Official First Name:
E. DEVI
Authorized Official Middle Name:
Authorized Official Title or Position:
VP
Authorized Official Telephone Number:
808-637-4550

Provider Taxonomy Codes

  • Taxonomy code: 1223G0001X , with the licence number:  DT 1707 , registered in the state of HI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 1223G0001X , with the licence number: DT 1739 , registered in the state of HI ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)