Provider Demographics
NPI:1568672756
Name:OKA, GARRETT BK (DDS)
Entity Type:Individual
Prefix:DR
First Name:GARRETT
Middle Name:BK
Last Name:OKA
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 1:75-5660 KOPIKO ST
Mailing Address - Street 2:#B2
Mailing Address - City:KAILUA KONA
Mailing Address - State:HI
Mailing Address - Zip Code:96740-3611
Mailing Address - Country:US
Mailing Address - Phone:808-329-0889
Mailing Address - Fax:
Practice Address - Street 1:75-5660 KOPIKO ST
Practice Address - Street 2:#B2
Practice Address - City:KAILUA KONA
Practice Address - State:HI
Practice Address - Zip Code:96740-3611
Practice Address - Country:US
Practice Address - Phone:808-329-0889
Practice Address - Fax:808-329-5062
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI19871223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice