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General NPI Number Information
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NPI Number | 1225619505
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Entity Type | Organization
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Legal Business Name | RODNEY N. NISHIMOTO, DMD, MD, LLC
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Dates
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Enumeration Date | 04/18/2021
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Last Update Date | 09/20/2021
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Provider Practice Location Address
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Address Line | 900 PUNAHOU ST STE 101
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City | HONOLULU
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State | HI
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Zip | 96826-2500
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Country | US
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Telephone | 808-949-8681
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Fax | 808-949-2488
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Provider Business Mailing Address
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Address Line | 900 PUNAHOU ST STE 101
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City | HONOLULU
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State | HI
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Zip | 96826-2500
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Country | US
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Telephone | 808-949-8681
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Fax | 808-949-2488
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Authorized Official
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Title or Position | MEMBER
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Name | DR. RODNEY NAKANO NISHIMOTO
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Credential | DMD, MD
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Telephone | 808-739-5678
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number |
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License Number State |
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