Provider Demographics
NPI:1073847588
Name:BENJAMIN KOIKE D.D.S., INC.
Entity Type:Organization
Organization Name:BENJAMIN KOIKE D.D.S., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:
Authorized Official - Last Name:KOIKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-732-1221
Mailing Address - Street 1:4211 WAIALAE AVE STE 401
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96816-5317
Mailing Address - Country:US
Mailing Address - Phone:808-732-1221
Mailing Address - Fax:
Practice Address - Street 1:4211 WAIALAE AVE STE 401
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96816-5317
Practice Address - Country:US
Practice Address - Phone:808-732-1221
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-30
Last Update Date:2009-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty