MEDICARE: DR. DEREK NEEQUI TAKAI D.D.S.

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	2052	HI

General Provider Information

NPI Number	:	1811199136
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DEREK NEEQUI TAKAI D.D.S.

Provider Business Mailing Address
First Line	:	4211 WAIALAE AVE STE 210
Second Line	:
City	:	HONOLULU
State	:	HI
Zip	:	96816-5312
Country	:	US
Telephone Number	:	808-732-1424
Fax Number	:	808-732-4077

Provider Business Practice Location Address
First Line	:	4211 WAIALAE AVE STE 210
Second Line	:
City	:	HONOLULU
State	:	HI
Zip	:	96816-5312
Country	:	US
Telephone Number	:	808-732-1424
Fax Number	:	808-732-4077

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

Provider Enumeration Date	:	05/31/2007
Last Update Date	:	01/13/2021

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