Provider Demographics
NPI:1437136769
Name:SUMIDA, EMILIE (DDS)
Entity Type:Individual
Prefix:DR
First Name:EMILIE
Middle Name:
Last Name:SUMIDA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1881 NANI ST
Mailing Address - Street 2:
Mailing Address - City:WAILUKU
Mailing Address - State:HI
Mailing Address - Zip Code:96793-1811
Mailing Address - Country:US
Mailing Address - Phone:808-872-4055
Mailing Address - Fax:808-872-4029
Practice Address - Street 1:1881 NANI ST
Practice Address - Street 2:
Practice Address - City:WAILUKU
Practice Address - State:HI
Practice Address - Zip Code:96793-1811
Practice Address - Country:US
Practice Address - Phone:808-872-4055
Practice Address - Fax:808-872-4029
Is Sole Proprietor?:No
Enumeration Date:2005-12-28
Last Update Date:2018-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIDT-25721223P0221X
NY052208-11223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
No1223G0001XDental ProvidersDentistGeneral Practice