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General NPI Number Information
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NPI Number | 1366115891
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Entity Type | Individual
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Provider Name | KRISTI C KOYANAGI DDS
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Gender | Female
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Dates
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Enumeration Date | 07/29/2021
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Last Update Date | 03/15/2022
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Provider Practice Location Address
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Address Line | 1060 YOUNG ST STE 305
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City | HONOLULU
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State | HI
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Zip | 96814-1609
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Country | US
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Telephone | 808-528-1200
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Fax |
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Provider Business Mailing Address
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Address Line | 1301 HONOKAHUA ST
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City | HONOLULU
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State | HI
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Zip | 96825-3012
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Country | US
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Telephone | 808-230-1348
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DT-2922
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License Number State | HI
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