Provider Demographics
NPI:1578099776
Name:WAIPAHU DENTISTS LLC
Entity Type:Organization
Organization Name:WAIPAHU DENTISTS LLC
Other - Org Name:HAWAII DENTAL CLINIC - WAIPAHU
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:AARON
Authorized Official - Middle Name:MT
Authorized Official - Last Name:HARADA
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:808-677-2451
Mailing Address - Street 1:94-050 FARRINGTON HWY # E1
Mailing Address - Street 2:
Mailing Address - City:WAIPAHU
Mailing Address - State:HI
Mailing Address - Zip Code:96797-1841
Mailing Address - Country:US
Mailing Address - Phone:808-677-2451
Mailing Address - Fax:
Practice Address - Street 1:94-050 FARRINGTON HWY # E1
Practice Address - Street 2:
Practice Address - City:WAIPAHU
Practice Address - State:HI
Practice Address - Zip Code:96797-1841
Practice Address - Country:US
Practice Address - Phone:808-677-2451
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-08
Last Update Date:2017-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI2545122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty