Healthcare Provider Details

I. General information

NPI: 1316075716
Provider Name (Legal Business Name): ENDODONTIC SPECIALISTS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/28/2007
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 WARD AVE SUITE 1015
HONOLULU HI
96814-1600
US

IV. Provider business mailing address

1100 WARD AVE SUITE 1015
HONOLULU HI
96814-1600
US

V. Phone/Fax

Practice location:
  • Phone: 808-532-3900
  • Fax: 808-532-3955
Mailing address:
  • Phone: 808-532-3900
  • Fax: 808-532-3955

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number
License Number StateHI

VIII. Authorized Official

Name: DR. GARY SHIGERU YONEMOTO
Title or Position: DENTIST
Credential: D.D.S., M.S.
Phone: 808-532-3900