Healthcare Provider Details

I. General information

NPI: 1154652600
Provider Name (Legal Business Name): BEN KAWASAKI, DDS, MSD, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/22/2010
Last Update Date: 01/22/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

321 N KUAKINI ST
HONOLULU HI
96817-2364
US

IV. Provider business mailing address

321 N KUAKINI ST
HONOLULU HI
96817-2364
US

V. Phone/Fax

Practice location:
  • Phone: 808-521-1896
  • Fax: 808-533-6443
Mailing address:
  • Phone: 808-521-1896
  • Fax: 808-533-6443

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number991
License Number StateHI

VIII. Authorized Official

Name: DR. BEN KAWASAKI
Title or Position: PRESIDENT OWNER
Credential: DDS
Phone: 808-521-1896