Provider Demographics
NPI:1811199136
Name:TAKAI, DEREK NEEQUI (DDS)
Entity Type:Individual
Prefix:DR
First Name:DEREK
Middle Name:NEEQUI
Last Name:TAKAI
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 1:4211 WAIALAE AVE STE 210
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96816-5312
Mailing Address - Country:US
Mailing Address - Phone:808-732-1424
Mailing Address - Fax:808-732-4077
Practice Address - Street 1:4211 WAIALAE AVE STE 210
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96816-5312
Practice Address - Country:US
Practice Address - Phone:808-732-1424
Practice Address - Fax:808-732-4077
Is Sole Proprietor?:No
Enumeration Date:2007-05-31
Last Update Date:2021-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI20521223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice