Provider Demographics
NPI:1376016030
Name:ARIELLE M NAGAO DDS LLC
Entity Type:Organization
Organization Name:ARIELLE M NAGAO DDS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ARIELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:NAGAO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:808-349-6257
Mailing Address - Street 1:94-300 FARRINGTON HWY STE F05
Mailing Address - Street 2:
Mailing Address - City:WAIPAHU
Mailing Address - State:HI
Mailing Address - Zip Code:96797-2648
Mailing Address - Country:US
Mailing Address - Phone:808-677-1566
Mailing Address - Fax:
Practice Address - Street 1:94-300 FARRINGTON HWY STE F05
Practice Address - Street 2:
Practice Address - City:WAIPAHU
Practice Address - State:HI
Practice Address - Zip Code:96797-2648
Practice Address - Country:US
Practice Address - Phone:808-677-1566
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-05
Last Update Date:2019-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental