Provider Demographics
NPI:1144380700
Name:SHIRAKI, CARLTON A (DDS)
Entity Type:Individual
Prefix:DR
First Name:CARLTON
Middle Name:A
Last Name:SHIRAKI
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 1:95-1249 MEHEULA PKWY
Mailing Address - Street 2:SUITE B-11
Mailing Address - City:MILILANI
Mailing Address - State:HI
Mailing Address - Zip Code:96789-1779
Mailing Address - Country:US
Mailing Address - Phone:808-625-5000
Mailing Address - Fax:808-627-0028
Practice Address - Street 1:95-1249 MEHEULA PKWY
Practice Address - Street 2:SUITE B-11
Practice Address - City:MILILANI
Practice Address - State:HI
Practice Address - Zip Code:96789-1763
Practice Address - Country:US
Practice Address - Phone:808-625-5000
Practice Address - Fax:808-627-0028
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI11281223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics