MEDICARE: JOEL K . YAP DDS, INC

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	1223G0001X	General Practice Dentistry	1766	HI

General Provider Information

NPI Number	:	1679705883
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JOEL K . YAP DDS, INC

Provider Business Mailing Address
First Line	:	615 PIIKOI ST STE 1201
Second Line	:
City	:	HONOLULU
State	:	HI
Zip	:	96814-3141
Country	:	US
Telephone Number	:	808-596-0890
Fax Number	:	808-356-0316

Provider Business Practice Location Address
First Line	:	615 PIIKOI ST STE 1201
Second Line	:
City	:	HONOLULU
State	:	HI
Zip	:	96814-3141
Country	:	US
Telephone Number	:	808-596-0890
Fax Number	:	808-356-0316

Authorized Official
Title or Position	:	PRESIDENT
Name	:	JOEL KEITH YAP
Credential	:	DDS
Telephone Number	:	808-596-0890

Provider Enumeration Date	:	08/20/2009
Last Update Date	:	08/20/2009

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