Provider Demographics
NPI:1801006341
Name:IGAWA, CHRIS KAZUMI (DDS)
Entity Type:Individual
Prefix:DR
First Name:CHRIS
Middle Name:KAZUMI
Last Name:IGAWA
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:91 LANIHULI ST
Mailing Address - Street 2:
Mailing Address - City:HILO
Mailing Address - State:HI
Mailing Address - Zip Code:96720-4142
Mailing Address - Country:US
Mailing Address - Phone:808-935-8909
Mailing Address - Fax:808-969-1558
Practice Address - Street 1:91 LANIHULI ST
Practice Address - Street 2:
Practice Address - City:HILO
Practice Address - State:HI
Practice Address - Zip Code:96720-4142
Practice Address - Country:US
Practice Address - Phone:808-935-8909
Practice Address - Fax:808-969-1558
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI2097122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist