Provider Demographics
NPI:1598816183
Name:KANEDA, GLENN MASAMI (DDS)
Entity Type:Individual
Prefix:DR
First Name:GLENN
Middle Name:MASAMI
Last Name:KANEDA
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 1:45 AULIKE ST
Mailing Address - Street 2:SUITE 45
Mailing Address - City:KAILUA
Mailing Address - State:HI
Mailing Address - Zip Code:96734-2708
Mailing Address - Country:US
Mailing Address - Phone:808-262-6000
Mailing Address - Fax:808-261-5549
Practice Address - Street 1:45 AULIKE ST
Practice Address - Street 2:SUITE 45
Practice Address - City:KAILUA
Practice Address - State:HI
Practice Address - Zip Code:96734-2708
Practice Address - Country:US
Practice Address - Phone:808-262-6000
Practice Address - Fax:808-261-5549
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIHI 11001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice