Provider Demographics
NPI:1649405937
Name:MICHAEL G. CHING, D.D.S., M.S., & SUSAN N. MIZUNO, D.D.S., M.S., INC.
Entity Type:Organization
Organization Name:MICHAEL G. CHING, D.D.S., M.S., & SUSAN N. MIZUNO, D.D.S., M.S., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CASSIE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:ITO-ALMAREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-525-7167
Mailing Address - Street 1:1060 YOUNG ST
Mailing Address - Street 2:STE. 216
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96814-1609
Mailing Address - Country:US
Mailing Address - Phone:808-525-7161
Mailing Address - Fax:808-525-7127
Practice Address - Street 1:1060 YOUNG ST
Practice Address - Street 2:STE. 216
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-1609
Practice Address - Country:US
Practice Address - Phone:808-525-7161
Practice Address - Fax:808-525-7127
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-15
Last Update Date:2009-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI18141223P0300X
HI19081223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0300XDental ProvidersDentistPeriodonticsGroup - Single Specialty