Provider Demographics
NPI:1568563658
Name:NAKAMURA, DULCIANNE Y (OD)
Entity Type:Individual
Prefix:DR
First Name:DULCIANNE
Middle Name:Y
Last Name:NAKAMURA
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:DULCIANNE
Other - Middle Name:Y
Other - Last Name:SUZUKI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OD
Mailing Address - Street 1:1010 PENSACOLA ST
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96814-2118
Mailing Address - Country:US
Mailing Address - Phone:808-432-2000
Mailing Address - Fax:
Practice Address - Street 1:1010 PENSACOLA ST
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-2118
Practice Address - Country:US
Practice Address - Phone:808-432-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2021-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIOD-561152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI0000236745OtherHMSA BILLING NUMBER
HI508400-01Medicaid
HI508400-01Medicaid
HIH54743Medicare PIN