Provider Demographics
NPI:1083732242
Name:DAVID T. OHARA D.D.S., INC.
Entity Type:Organization
Organization Name:DAVID T. OHARA D.D.S., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:T
Authorized Official - Last Name:OHARA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:808-677-4508
Mailing Address - Street 1:PO BOX 938
Mailing Address - Street 2:
Mailing Address - City:AIEA
Mailing Address - State:HI
Mailing Address - Zip Code:96701-0938
Mailing Address - Country:US
Mailing Address - Phone:808-677-4508
Mailing Address - Fax:
Practice Address - Street 1:94-889 WAIPAHU ST STE 105
Practice Address - Street 2:
Practice Address - City:WAIPAHU
Practice Address - State:HI
Practice Address - Zip Code:96797-3352
Practice Address - Country:US
Practice Address - Phone:808-677-4508
Practice Address - Fax:808-676-1805
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-27
Last Update Date:2020-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIDT-1742122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI00588401Medicaid
HI5363Medicare ID - Type Unspecified