Provider Demographics
NPI:1326248238
Name:MORIOKA, JOHN K (DDS)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:K
Last Name:MORIOKA
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 1:850 W HIND DR
Mailing Address - Street 2:SUITE 206
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96821-1891
Mailing Address - Country:US
Mailing Address - Phone:808-377-5266
Mailing Address - Fax:
Practice Address - Street 1:850 W HIND DR
Practice Address - Street 2:SUITE 206
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96821-1891
Practice Address - Country:US
Practice Address - Phone:808-377-5266
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-19
Last Update Date:2016-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI2336122300000X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1301071Medicaid