Provider Demographics
NPI:1073947677
Name:OMURA, AARON JAY (DMD)
Entity Type:Individual
Prefix:DR
First Name:AARON
Middle Name:JAY
Last Name:OMURA
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1150 S KING ST
Mailing Address - Street 2:STE #305
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96814-1922
Mailing Address - Country:US
Mailing Address - Phone:808-593-2999
Mailing Address - Fax:808-593-2929
Practice Address - Street 1:1150 S KING ST
Practice Address - Street 2:STE #305
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-1922
Practice Address - Country:US
Practice Address - Phone:808-593-2999
Practice Address - Fax:808-593-2929
Is Sole Proprietor?:No
Enumeration Date:2013-08-30
Last Update Date:2013-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIDT25161223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice