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NPI Code Detail

MEDICARE: STEVEN K. SUE, D.D.S., M.S., INC.

MEDICARE: STEVEN K. SUE, D.D.S., M.S., INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1305R00000XPreferred Provider Organization790HI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11487888913OTHERHINPI TYPE 1

General Provider Information

NPI Number : 1457587735
Entity Type Code : Organization
Provider Name (Legal Business Name) : STEVEN K. SUE, D.D.S., M.S., INC.
Provider Business Mailing Address
First Line : 2065 S KING ST STE 304
Second Line :
City : HONOLULU
State : HI
Zip : 96826-2225
Country : US
Telephone Number : 808-949-8876
Fax Number : 808-949-8878
Provider Business Practice Location Address
First Line : 2065 S KING ST STE 304
Second Line :
City : HONOLULU
State : HI
Zip : 96826-2225
Country : US
Telephone Number : 808-949-8876
Fax Number : 808-949-8878
Authorized Official
Title or Position : PRESIDENT
Name : DR. STEVEN SUE
Credential : D.D.S.
Telephone Number : 808-949-8876
Provider Enumeration Date : 06/01/2009
Last Update Date : 06/01/2009

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1487888913 — DR. STEVEN K. SUE D.D.S.
Practice Location Address:
2065 S KING ST STE 304
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96826-2225
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Practice Fax: 808-949-8878

Directions to “STEVEN K. SUE, D.D.S., M.S., INC. ” Practice Location

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