Provider Demographics
NPI:1467427039
Name:LONG, DENNIS C (MD)
Entity Type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:C
Last Name:LONG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:941 KAMEHAMEHA HWY
Mailing Address - Street 2:STE 208
Mailing Address - City:PEARL CITY
Mailing Address - State:HI
Mailing Address - Zip Code:96782-2516
Mailing Address - Country:US
Mailing Address - Phone:808-454-5200
Mailing Address - Fax:808-454-5201
Practice Address - Street 1:1319 PUNAHOO ST
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96826
Practice Address - Country:US
Practice Address - Phone:808-983-8626
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-17
Last Update Date:2007-07-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
HI69292085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology