Provider Demographics
NPI:1356685341
Name:DENNIS T. NAGATA DDS INC
Entity Type:Organization
Organization Name:DENNIS T. NAGATA DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:TSUGIO
Authorized Official - Last Name:NAGATA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:808-526-0670
Mailing Address - Street 1:1520 LILIHA ST.
Mailing Address - Street 2:SUITE 703
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96817
Mailing Address - Country:US
Mailing Address - Phone:808-526-0670
Mailing Address - Fax:808-536-3116
Practice Address - Street 1:1520 LILIHA ST.
Practice Address - Street 2:SUITE 703
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96817
Practice Address - Country:US
Practice Address - Phone:808-526-0670
Practice Address - Fax:808-536-3116
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-15
Last Update Date:2013-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI1105122300000X
332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized EquipmentGroup - Single Specialty