MEDICARE: DWIGHT ISAMU INOUYE DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	1063	HI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	88369	OTHER	HI	HMSA
3	0106301	OTHER	HI	HOS

General Provider Information

NPI Number	:	1144364803
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DWIGHT ISAMU INOUYE DDS

Provider Business Mailing Address
First Line	:	2153 N KING ST
Second Line	:	#314
City	:	HONOLULU
State	:	HI
Zip	:	96819-4559
Country	:	US
Telephone Number	:	808-847-3702
Fax Number	:

Provider Business Practice Location Address
First Line	:	2153 N KING ST
Second Line	:	#314
City	:	HONOLULU
State	:	HI
Zip	:	96819-4559
Country	:	US
Telephone Number	:	808-847-3702
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/16/2007
Last Update Date	:	07/08/2007

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