Provider Demographics
NPI:1659346831
Name:DANNA, STEVEN SAMUEL (DDS)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:SAMUEL
Last Name:DANNA
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 1:480 CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:JBPHH
Mailing Address - State:HI
Mailing Address - Zip Code:96860-4908
Mailing Address - Country:US
Mailing Address - Phone:808-474-4242
Mailing Address - Fax:808-471-0918
Practice Address - Street 1:480 CENTRAL AVENUE,
Practice Address - Street 2:NAVAL HEALTH CLINIC HAWAII
Practice Address - City:JBPHH
Practice Address - State:HI
Practice Address - Zip Code:96860
Practice Address - Country:US
Practice Address - Phone:808-471-1866
Practice Address - Fax:808-471-0918
Is Sole Proprietor?:No
Enumeration Date:2006-02-21
Last Update Date:2020-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019.0191081223G0001X
IL019-019108122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1659346831OtherUSN