Provider Demographics
NPI:1437649209
Name:CINDY S. KUBOTA, DMD LLC
Entity Type:Organization
Organization Name:CINDY S. KUBOTA, DMD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JADE
Authorized Official - Middle Name:
Authorized Official - Last Name:KANO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-455-1973
Mailing Address - Street 1:812 LEHUA AVE STE D
Mailing Address - Street 2:
Mailing Address - City:PEARL CITY
Mailing Address - State:HI
Mailing Address - Zip Code:96782-3621
Mailing Address - Country:US
Mailing Address - Phone:808-455-1973
Mailing Address - Fax:808-455-3488
Practice Address - Street 1:812 LEHUA AVE STE D
Practice Address - Street 2:
Practice Address - City:PEARL CITY
Practice Address - State:HI
Practice Address - Zip Code:96782-3621
Practice Address - Country:US
Practice Address - Phone:808-455-1973
Practice Address - Fax:808-455-3488
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-16
Last Update Date:2018-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty