Healthcare Provider Details

I. General information

NPI: 1982601753
Provider Name (Legal Business Name): MICHAEL K SAKUDA DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/07/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40 AULIKE ST SUITE 214
KAILUA HI
96734-2758
US

IV. Provider business mailing address

40 AULIKE ST SUITE 214
KAILUA HI
96734-2758
US

V. Phone/Fax

Practice location:
  • Phone: 808-261-1968
  • Fax: 808-262-6232
Mailing address:
  • Phone: 808-261-1968
  • Fax: 808-262-6232

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDT1902
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: