Provider Demographics
NPI:1518060979
Name:KOYANAGI, REID TAKESHI (DDS)
Entity Type:Individual
Prefix:DR
First Name:REID
Middle Name:TAKESHI
Last Name:KOYANAGI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:934 PUNAHOU ST
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96826-2522
Mailing Address - Country:US
Mailing Address - Phone:808-949-7333
Mailing Address - Fax:808-951-9028
Practice Address - Street 1:934 PUNAHOU ST
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96826-2522
Practice Address - Country:US
Practice Address - Phone:808-949-7333
Practice Address - Fax:808-951-9028
Is Sole Proprietor?:No
Enumeration Date:2006-09-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIDT2026122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist