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General NPI Number Information
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NPI Number | 1619849874
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Entity Type | Organization
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Legal Business Name | NISHIOKA DMD LLC
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Dates
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Enumeration Date | 09/18/2025
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Last Update Date | 09/18/2025
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Provider Practice Location Address
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Address Line | 85-761 FARRINGTON HWY
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City | WAIANAE
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State | HI
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Zip | 96792-2463
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Country | US
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Telephone | 808-696-7575
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Fax |
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Provider Business Mailing Address
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Address Line | 85-761 FARRINGTON HWY
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City | WAIANAE
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State | HI
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Zip | 96792-2463
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Country | US
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Telephone | 808-696-7575
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | KYLEE LEIDHOLT NISHIOKA
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Credential | DMD
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Telephone | 406-951-1345
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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 |
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License Number State |
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