Provider Demographics
NPI:1275697112
Name:MAYEDA, DANIEL TADASHI X (DDS)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:TADASHI
Last Name:MAYEDA
Suffix:X
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 1:74 LONO AVE
Mailing Address - Street 2:SUITE 210
Mailing Address - City:KAHULUI
Mailing Address - State:HI
Mailing Address - Zip Code:96732-1626
Mailing Address - Country:US
Mailing Address - Phone:808-877-7661
Mailing Address - Fax:808-871-0891
Practice Address - Street 1:74 LONO AVE
Practice Address - Street 2:SUITE 210
Practice Address - City:KAHULUI
Practice Address - State:HI
Practice Address - Zip Code:96732-1626
Practice Address - Country:US
Practice Address - Phone:808-877-7661
Practice Address - Fax:808-871-0891
Is Sole Proprietor?:No
Enumeration Date:2006-12-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI9941223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice