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General NPI Number Information
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NPI Number | 1023363421
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Entity Type | Organization
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Legal Business Name | DOUGLAS S. SHIRAKI, D.D.S., INC.
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Dates
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Enumeration Date | 07/23/2012
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Last Update Date | 07/23/2012
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Provider Practice Location Address
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Address Line | 1010 S KING ST STE B2
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City | HONOLULU
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State | HI
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Zip | 96814-1775
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Country | US
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Telephone | 808-593-2324
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Fax | 808-596-7947
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Provider Business Mailing Address
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Address Line | 1010 S KING ST STE B2
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City | HONOLULU
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State | HI
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Zip | 96814-1775
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Country | US
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Telephone | 808-593-2324
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Fax | 808-596-7947
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DOUGLAS S. SHIRAKI
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Credential | D.D.S.
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Telephone | 808-593-2324
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | DT-1457
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License Number State | HI
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