Provider Demographics
NPI:1619100716
Name:MYRON 'SKIP' KAWAKAMI D.D.S., INC.
Entity Type:Organization
Organization Name:MYRON 'SKIP' KAWAKAMI D.D.S., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MYRON
Authorized Official - Middle Name:E
Authorized Official - Last Name:KAWAKAMI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:808-487-3355
Mailing Address - Street 1:98-1238 KAAHUMANU ST STE 305
Mailing Address - Street 2:
Mailing Address - City:PEARL CITY
Mailing Address - State:HI
Mailing Address - Zip Code:96782-3250
Mailing Address - Country:US
Mailing Address - Phone:808-487-3355
Mailing Address - Fax:
Practice Address - Street 1:98-1238 KAAHUMANU ST STE 305
Practice Address - Street 2:
Practice Address - City:PEARL CITY
Practice Address - State:HI
Practice Address - Zip Code:96782-3250
Practice Address - Country:US
Practice Address - Phone:808-487-3355
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-24
Last Update Date:2009-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI8777122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI8777OtherHAWAII DENTAL SERVICE
HI0000044388OtherHAWAII MEDICAL SERVICE ASSOCIATION
HI674001OtherUNITED CONCORDIA