Provider Demographics
NPI:1700385606
Name:POON, ANTHONY (DMD)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:
Last Name:POON
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1441 KAPIOLANI BLVD
Mailing Address - Street 2:SUITE 720, ALA MOANA BLDG
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96814
Mailing Address - Country:US
Mailing Address - Phone:808-949-1607
Mailing Address - Fax:
Practice Address - Street 1:1441 KAPIOLANI BLVD
Practice Address - Street 2:SUITE 720, ALA MOANA BLDG
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814
Practice Address - Country:US
Practice Address - Phone:808-949-1607
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-06
Last Update Date:2018-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIDT-14151223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice