Provider Demographics
NPI:1275848624
Name:PAUL K. TANAKA DDS INC.
Entity Type:Organization
Organization Name:PAUL K. TANAKA DDS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:K
Authorized Official - Last Name:TANAKA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:808-737-6229
Mailing Address - Street 1:4747 KILAUEA AVE
Mailing Address - Street 2:SUITE 113
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96816-5308
Mailing Address - Country:US
Mailing Address - Phone:808-737-6229
Mailing Address - Fax:
Practice Address - Street 1:4747 KILAUEA AVE
Practice Address - Street 2:SUITE 113
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96816-5308
Practice Address - Country:US
Practice Address - Phone:808-737-6229
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-10
Last Update Date:2010-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI12771223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty