Provider Demographics
NPI:1700042124
Name:MUKAI, TINA NATALIE (DDS)
Entity Type:Individual
Prefix:DR
First Name:TINA
Middle Name:NATALIE
Last Name:MUKAI
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:95-1249 MEHEULA PKWY
Mailing Address - Street 2:SUITE 115
Mailing Address - City:MILILANI
Mailing Address - State:HI
Mailing Address - Zip Code:96789-1779
Mailing Address - Country:US
Mailing Address - Phone:808-623-2888
Mailing Address - Fax:
Practice Address - Street 1:95-1249 MEHEULA PKWY
Practice Address - Street 2:SUITE 115
Practice Address - City:MILILANI
Practice Address - State:HI
Practice Address - Zip Code:96789-1779
Practice Address - Country:US
Practice Address - Phone:808-623-2888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-05
Last Update Date:2010-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIDT-23011223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice