Provider Demographics
NPI:1689860058
Name:IMAI, LAUREN JM (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:LAUREN
Middle Name:JM
Last Name:IMAI
Suffix:
Gender:F
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:98-150 KAONOHI ST STE C207
Mailing Address - Street 2:
Mailing Address - City:AIEA
Mailing Address - State:HI
Mailing Address - Zip Code:96701-5022
Mailing Address - Country:US
Mailing Address - Phone:808-488-0100
Mailing Address - Fax:
Practice Address - Street 1:98-150 KAONOHI ST STE C207
Practice Address - Street 2:
Practice Address - City:AIEA
Practice Address - State:HI
Practice Address - Zip Code:96701-5022
Practice Address - Country:US
Practice Address - Phone:808-488-0100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-19
Last Update Date:2007-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI23131223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry