Healthcare Provider Details

I. General information

NPI: 1144378654
Provider Name (Legal Business Name): WILLIAM JOSEPH ENOKA D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/08/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4211 WAIALAE AVE SUITE 501
HONOLULU HI
96816-5306
US

IV. Provider business mailing address

4211 WAIALAE AVE SUITE 501
HONOLULU HI
96816-5306
US

V. Phone/Fax

Practice location:
  • Phone: 808-732-4377
  • Fax: 808-732-4158
Mailing address:
  • Phone: 808-732-4377
  • Fax: 808-732-4158

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDT-1870
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: