Provider Demographics
NPI:1215006135
Name:UEHARA, KEITH Y, (DDS)
Entity Type:Individual
Prefix:DR
First Name:KEITH
Middle Name:Y,
Last Name:UEHARA
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 1:3135 AKAHI ST
Mailing Address - Street 2:SUITE D
Mailing Address - City:LIHUE
Mailing Address - State:HI
Mailing Address - Zip Code:96766-1191
Mailing Address - Country:US
Mailing Address - Phone:808-246-6370
Mailing Address - Fax:
Practice Address - Street 1:3135 AKAHI ST
Practice Address - Street 2:SUITE D
Practice Address - City:LIHUE
Practice Address - State:HI
Practice Address - Zip Code:96766-1191
Practice Address - Country:US
Practice Address - Phone:808-246-6370
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIDT-1755122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist