Provider Demographics
NPI:1407907512
Name:KAWASAKI, BEN T (DDS,MSD)
Entity Type:Individual
Prefix:
First Name:BEN
Middle Name:T
Last Name:KAWASAKI
Suffix:
Gender:M
Credentials:DDS,MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:321 N KUAKINI ST STE 804
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96817-2362
Mailing Address - Country:US
Mailing Address - Phone:808-521-1896
Mailing Address - Fax:808-533-6443
Practice Address - Street 1:321 N KUAKINI ST STE 804
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96817-2362
Practice Address - Country:US
Practice Address - Phone:808-521-1896
Practice Address - Fax:808-533-6443
Is Sole Proprietor?:No
Enumeration Date:2007-01-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI9911223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI52720OtherHAWAIIMEDICALSERVICEASSOC
HI046397-04OtherMEDICAID
HI52720OtherHAWAIIMEDICALSERVICEASSOC