Provider Demographics
NPI:1063661221
Name:KANESHIRO, MARTIN M (DDS)
Entity Type:Individual
Prefix:DR
First Name:MARTIN
Middle Name:M
Last Name:KANESHIRO
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:98-211 PALI MOMI ST
Mailing Address - Street 2:STE. #737
Mailing Address - City:AIEA
Mailing Address - State:HI
Mailing Address - Zip Code:96701-4301
Mailing Address - Country:US
Mailing Address - Phone:808-487-1554
Mailing Address - Fax:808-487-1556
Practice Address - Street 1:98-211 PALI MOMI ST
Practice Address - Street 2:STE. #737
Practice Address - City:AIEA
Practice Address - State:HI
Practice Address - Zip Code:96701-4301
Practice Address - Country:US
Practice Address - Phone:808-487-1554
Practice Address - Fax:808-487-1556
Is Sole Proprietor?:No
Enumeration Date:2008-09-11
Last Update Date:2008-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI6201223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice