Provider Demographics
NPI:1407828205
Name:MIYAGAWA, GARRET G (DDS)
Entity Type:Individual
Prefix:DR
First Name:GARRET
Middle Name:G
Last Name:MIYAGAWA
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 1:46-022 KAM HWY
Mailing Address - Street 2:
Mailing Address - City:KANEOHE
Mailing Address - State:HI
Mailing Address - Zip Code:96744-3714
Mailing Address - Country:US
Mailing Address - Phone:808-247-2700
Mailing Address - Fax:808-247-2700
Practice Address - Street 1:46-022 KAM HWY
Practice Address - Street 2:RM. #201
Practice Address - City:KANEOHE
Practice Address - State:HI
Practice Address - Zip Code:96744-3714
Practice Address - Country:US
Practice Address - Phone:808-247-2700
Practice Address - Fax:808-247-2700
Is Sole Proprietor?:No
Enumeration Date:2006-02-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI16211223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice