Provider Demographics
NPI:1003049511
Name:DAVID H. OTA, DDS., INC
Entity Type:Organization
Organization Name:DAVID H. OTA, DDS., INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:HARUO
Authorized Official - Last Name:OTA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:808-373-9895
Mailing Address - Street 1:850 W HIND DR
Mailing Address - Street 2:SUITE 115
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96821-1855
Mailing Address - Country:US
Mailing Address - Phone:808-373-9895
Mailing Address - Fax:
Practice Address - Street 1:850 W HIND DR
Practice Address - Street 2:SUITE 115
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96821-1855
Practice Address - Country:US
Practice Address - Phone:808-373-9895
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-31
Last Update Date:2009-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI883122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty