=====================================================
General NPI Number Information
=====================================================
NPI Number | 1285866178
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | WENDY ANN N WAKAI, DMD INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/11/2009
-----------------------------------------------------
Last Update Date | 08/11/2009
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1268 YOUNG ST STE 202
-----------------------------------------------------
City | HONOLULU
-----------------------------------------------------
State | HI
-----------------------------------------------------
Zip | 96814-1801
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 808-593-8861
-----------------------------------------------------
Fax | 808-593-8862
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1268 YOUNG ST STE 202
-----------------------------------------------------
City | HONOLULU
-----------------------------------------------------
State | HI
-----------------------------------------------------
Zip | 96814-1801
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 808-593-8661
-----------------------------------------------------
Fax | 808-593-6682
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DOCTOR
-----------------------------------------------------
Name | DR. WENDY ANN N WAKAI
-----------------------------------------------------
Credential | D.M.D.
-----------------------------------------------------
Telephone | 808-593-8861
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1223G0001X
-----------------------------------------------------
Taxonomy Name | General Practice Dentistry
-----------------------------------------------------
License Number | DT-1559
-----------------------------------------------------
License Number State | HI
-----------------------------------------------------