Provider Demographics
NPI:1730494931
Name:MICHINO, JAMES MASATAKA (DMD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:MASATAKA
Last Name:MICHINO
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Gender:M
Credentials:DMD
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Mailing Address - Street 1:1580 MAKALOA STREET
Mailing Address - Street 2:SUITE 725
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96814-3216
Mailing Address - Country:US
Mailing Address - Phone:808-973-3747
Mailing Address - Fax:808-973-3757
Practice Address - Street 1:1580 MAKALOA STREET
Practice Address - Street 2:SUITE 725
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-6216
Practice Address - Country:US
Practice Address - Phone:808-973-3747
Practice Address - Fax:808-973-3757
Is Sole Proprietor?:No
Enumeration Date:2010-08-11
Last Update Date:2011-11-09
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Provider Licenses
StateLicense IDTaxonomies
CA560441223S0112X
HI23021223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery