Provider Demographics
NPI:1235857970
Name:TAMASHIRO, KASEY-KALEI ANNE (DMD)
Entity Type:Individual
Prefix:DR
First Name:KASEY-KALEI
Middle Name:ANNE
Last Name:TAMASHIRO
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1728 WILI PA LOOP STE 100
Mailing Address - Street 2:
Mailing Address - City:WAILUKU
Mailing Address - State:HI
Mailing Address - Zip Code:96793-1284
Mailing Address - Country:US
Mailing Address - Phone:808-264-2842
Mailing Address - Fax:
Practice Address - Street 1:1728 WILI PA LOOP STE 100
Practice Address - Street 2:
Practice Address - City:WAILUKU
Practice Address - State:HI
Practice Address - Zip Code:96793-1284
Practice Address - Country:US
Practice Address - Phone:808-264-2842
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-18
Last Update Date:2022-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIDT-30141223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice