Provider Demographics
NPI:1205860269
Name:SEWAKE, IRWIN HISASHI (DDS)
Entity Type:Individual
Prefix:DR
First Name:IRWIN
Middle Name:HISASHI
Last Name:SEWAKE
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 1:94-873 FARRINGTON HWY
Mailing Address - Street 2:SUITE #202
Mailing Address - City:WAIPAHU
Mailing Address - State:HI
Mailing Address - Zip Code:96797-3150
Mailing Address - Country:US
Mailing Address - Phone:808-677-4041
Mailing Address - Fax:
Practice Address - Street 1:94-873 FARRINGTON HWY
Practice Address - Street 2:SUITE #202
Practice Address - City:WAIPAHU
Practice Address - State:HI
Practice Address - Zip Code:96797-3150
Practice Address - Country:US
Practice Address - Phone:808-677-4041
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI16511223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI1651OtherHDS
HI7937-6OtherHMSA