Healthcare Provider Details

I. General information

NPI: 1639594104
Provider Name (Legal Business Name): ERIN MARIKO UWAINE D.D.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/20/2014
Last Update Date: 08/24/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 KAPIOLANI BLD STE 204
HONOLULU HI
96813
US

IV. Provider business mailing address

600 KAPIOLANI BLVD STE 204
HONOLULU HI
96813-5147
US

V. Phone/Fax

Practice location:
  • Phone: 808-533-2861
  • Fax:
Mailing address:
  • Phone: 808-533-2861
  • Fax: 808-533-3761

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number2532
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: