Healthcare Provider Details

I. General information

NPI: 1851451686
Provider Name (Legal Business Name): DAVID T OHARA D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/11/2006
Last Update Date: 04/06/2020
Certification Date: 04/06/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

94-889 WAIPAHU ST STE 105
WAIPAHU HI
96797-3352
US

IV. Provider business mailing address

PO BOX 938
AIEA HI
96701-0938
US

V. Phone/Fax

Practice location:
  • Phone: 808-677-4508
  • Fax: 808-676-1805
Mailing address:
  • Phone: 808-677-4508
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDT-1742
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: