Provider Demographics
NPI:1639432792
Name:NAYAK, SATYAPRASAD C (DMD)
Entity Type:Individual
Prefix:
First Name:SATYAPRASAD
Middle Name:C
Last Name:NAYAK
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45-939 KAMEHAMEHA HWY STE 103
Mailing Address - Street 2:
Mailing Address - City:KANEOHE
Mailing Address - State:HI
Mailing Address - Zip Code:96744-3221
Mailing Address - Country:US
Mailing Address - Phone:808-247-6039
Mailing Address - Fax:
Practice Address - Street 1:45-939 KAMEHAMEHA HWY STE 103
Practice Address - Street 2:
Practice Address - City:KANEOHE
Practice Address - State:HI
Practice Address - Zip Code:96744-3221
Practice Address - Country:US
Practice Address - Phone:808-247-6039
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-22
Last Update Date:2020-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
HIDT27551223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program