Healthcare Provider Details

I. General information

NPI: 1457339186
Provider Name (Legal Business Name): SUNAHARA DENTAL, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/03/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

66-230 KAMEHAMEHA HWY
HALEIWA HI
96712-1421
US

IV. Provider business mailing address

66-230 KAMEHAMEHA HWY
HALEIWA HI
96712-1421
US

V. Phone/Fax

Practice location:
  • Phone: 808-637-4550
  • Fax: 808-637-4552
Mailing address:
  • Phone: 808-637-4550
  • Fax: 808-637-4552

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDT 1739
License Number StateHI
# 2
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDT 1707
License Number StateHI

VIII. Authorized Official

Name: DR. E. DEVI SUNAHARA
Title or Position: VP
Credential: D.D.S.
Phone: 808-637-4550