Provider Demographics
NPI:1083891410
Name:UMAKI, CLYDE S (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:CLYDE
Middle Name:S
Last Name:UMAKI
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1833 S BERETANIA ST
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96826-1307
Mailing Address - Country:US
Mailing Address - Phone:808-955-2275
Mailing Address - Fax:808-942-4608
Practice Address - Street 1:1833 S BERETANIA ST
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96826-1307
Practice Address - Country:US
Practice Address - Phone:808-955-2275
Practice Address - Fax:808-942-4608
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-28
Last Update Date:2008-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI8131223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics