Healthcare Provider Details

I. General information

NPI: 1023253747
Provider Name (Legal Business Name): JOHN P. OKA DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/09/2008
Last Update Date: 10/05/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

98-150 KAONOHI ST SUITE C-201
AIEA HI
96701-5047
US

IV. Provider business mailing address

98-150 KAONOHI ST SUITE C-201
AIEA HI
96701-5047
US

V. Phone/Fax

Practice location:
  • Phone: 808-488-3368
  • Fax:
Mailing address:
  • Phone: 808-488-3368
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDT2393
License Number StateHI
# 2
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number58074
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: