Provider Demographics
NPI:1457450819
Name:MIURA, ROBERT K
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:K
Last Name:MIURA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1221 KAPIOLANI BLVD
Mailing Address - Street 2:SUITE 848
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96814
Mailing Address - Country:US
Mailing Address - Phone:808-597-1221
Mailing Address - Fax:808-591-2070
Practice Address - Street 1:1221 KAPIOLANI BLVD
Practice Address - Street 2:SUITE 848
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814
Practice Address - Country:US
Practice Address - Phone:808-597-1221
Practice Address - Fax:808-591-2070
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI1158122300000X
HI1515122300000X
HI1318122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist