Healthcare Provider Details

I. General information

NPI: 1730384140
Provider Name (Legal Business Name): GREGG TADASHI UYEDA DDS, MS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/15/2007
Last Update Date: 02/13/2023
Certification Date: 02/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

932 WARD AVE SUITE 410
HONOLULU HI
96814-2131
US

IV. Provider business mailing address

1441 KAPIOLANI BLVD STE 800
HONOLULU HI
96814-4404
US

V. Phone/Fax

Practice location:
  • Phone: 808-533-7200
  • Fax: 808-533-1371
Mailing address:
  • Phone: 808-533-7200
  • Fax: 808-533-1371

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number1653
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: