Provider Demographics
NPI:1649412677
Name:ENDODONTIC SPECIALISTS, INC.
Entity Type:Organization
Organization Name:ENDODONTIC SPECIALISTS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:S
Authorized Official - Last Name:YONEMOTO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-483-4111
Mailing Address - Street 1:98-1247 KAAHUMANU ST
Mailing Address - Street 2:SUITE 218
Mailing Address - City:AIEA
Mailing Address - State:HI
Mailing Address - Zip Code:96701-5311
Mailing Address - Country:US
Mailing Address - Phone:808-483-4111
Mailing Address - Fax:
Practice Address - Street 1:98-1247 KAAHUMANU ST
Practice Address - Street 2:SUITE 218
Practice Address - City:AIEA
Practice Address - State:HI
Practice Address - Zip Code:96701-5311
Practice Address - Country:US
Practice Address - Phone:808-483-4111
Practice Address - Fax:808-483-4115
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ENDODONTIC SPECIALISTS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-04-06
Last Update Date:2009-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI10101223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Multi-Specialty