Provider Demographics
NPI:1275989238
Name:ALLAN Y. SEGAWA DDS INC
Entity Type:Organization
Organization Name:ALLAN Y. SEGAWA DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALLAN
Authorized Official - Middle Name:Y
Authorized Official - Last Name:SEGAWA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:808-623-0322
Mailing Address - Street 1:95-390 KUAHELANI AVE STE 2C
Mailing Address - Street 2:
Mailing Address - City:MILILANI
Mailing Address - State:HI
Mailing Address - Zip Code:96789-1182
Mailing Address - Country:US
Mailing Address - Phone:808-623-0322
Mailing Address - Fax:808-625-3642
Practice Address - Street 1:95-390 KUAHELANI AVE STE 2C
Practice Address - Street 2:
Practice Address - City:MILILANI
Practice Address - State:HI
Practice Address - Zip Code:96789-1182
Practice Address - Country:US
Practice Address - Phone:808-623-0322
Practice Address - Fax:808-625-3642
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-09
Last Update Date:2016-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI913122300000X
HI822122300000X
HI2612122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty