Provider Demographics
NPI:1568406635
Name:TAKAKI, GEORGE MAYNARD (DDS)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:MAYNARD
Last Name:TAKAKI
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 1:2035 LINOHAU WAY
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96822-2116
Mailing Address - Country:US
Mailing Address - Phone:808-955-2303
Mailing Address - Fax:
Practice Address - Street 1:45-946 KAM HWY
Practice Address - Street 2:
Practice Address - City:KANEOHE
Practice Address - State:HI
Practice Address - Zip Code:96744-3205
Practice Address - Country:US
Practice Address - Phone:808-235-5893
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI97821223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice