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General NPI Number Information
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NPI Number | 1669538914
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Entity Type | Organization
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Legal Business Name | BERT M. SUMIKAWA, D.D.S., INC.
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Dates
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Enumeration Date | 12/29/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1026 S KING ST
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City | HONOLULU
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State | HI
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Zip | 96814-2114
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Country | US
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Telephone | 808-593-8828
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Fax | 808-596-0248
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Provider Business Mailing Address
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Address Line | 1026 S KING ST
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City | HONOLULU
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State | HI
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Zip | 96814-2114
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Country | US
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Telephone | 808-593-8828
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Fax | 808-596-0248
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Authorized Official
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Title or Position | PREIDENT
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Name | DR. BERT MASAYOSHI SUMIKAWA
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Credential | D.D.S.
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Telephone | 808-593-8828
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 716
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License Number State | HI
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