Provider Demographics
NPI:1629105572
Name:KUROIWA, KEITH KATSUYUKI (DDS)
Entity Type:Individual
Prefix:DR
First Name:KEITH
Middle Name:KATSUYUKI
Last Name:KUROIWA
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 1:615 PIIKOI ST PH 3
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96814-3138
Mailing Address - Country:US
Mailing Address - Phone:808-596-2568
Mailing Address - Fax:
Practice Address - Street 1:615 PIIKOI ST PH 3
Practice Address - Street 2:PH-3
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-3138
Practice Address - Country:US
Practice Address - Phone:808-596-2568
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIDT13401223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice