Provider Demographics
NPI:1023363421
Name:DOUGLAS S. SHIRAKI, D.D.S., INC.
Entity Type:Organization
Organization Name:DOUGLAS S. SHIRAKI, D.D.S., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:S
Authorized Official - Last Name:SHIRAKI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:808-593-2324
Mailing Address - Street 1:1010 S KING ST STE B2
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96814-1775
Mailing Address - Country:US
Mailing Address - Phone:808-593-2324
Mailing Address - Fax:808-596-7947
Practice Address - Street 1:1010 S KING ST STE B2
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-1775
Practice Address - Country:US
Practice Address - Phone:808-593-2324
Practice Address - Fax:808-596-7947
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-23
Last Update Date:2012-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIDT-1457261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA836161OtherUNITED CONCORDIA
HI2566-8OtherHMSA
HI1457OtherHAWAII DENTAL SERVICE