Provider Demographics
NPI:1710034459
Name:JONATHAN C. OKABE DDS INC
Entity Type:Organization
Organization Name:JONATHAN C. OKABE DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE COORD.
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:OKABE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-833-1704
Mailing Address - Street 1:3425 ALA HINALO PL
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96818-2225
Mailing Address - Country:US
Mailing Address - Phone:808-833-1704
Mailing Address - Fax:
Practice Address - Street 1:3425 ALA HINALO PL
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96818-2225
Practice Address - Country:US
Practice Address - Phone:808-833-1704
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-04
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI9981223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIZ8780-0OtherHAWAII MEDICAL SERVICE
HI998OtherHAWAII DENTAL SERVICE