MEDICARE: DR. JASON W KAMEZAWA D.M.D.

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	1892	HI

General Provider Information

NPI Number	:	1780608950
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JASON W KAMEZAWA D.M.D.

Provider Business Mailing Address
First Line	:	1441 KAPIOLANI BLVD
Second Line	:	SUITE 1501
City	:	HONOLULU
State	:	HI
Zip	:	96814-4402
Country	:	US
Telephone Number	:	808-949-3314
Fax Number	:	808-946-6255

Provider Business Practice Location Address
First Line	:	1441 KAPIOLANI BLVD
Second Line	:	SUITE 1501
City	:	HONOLULU
State	:	HI
Zip	:	96814-4402
Country	:	US
Telephone Number	:	808-949-3314
Fax Number	:	808-946-6255

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

Provider Enumeration Date	:	07/27/2006
Last Update Date	:	07/08/2007

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