Provider Demographics
NPI:1821121153
Name:CHING, DWAYNE YUEN FAH (DDS)
Entity Type:Individual
Prefix:DR
First Name:DWAYNE
Middle Name:YUEN FAH
Last Name:CHING
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 1:1520 LILIHA STREET.
Mailing Address - Street 2:SUITE 606
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96817-3564
Mailing Address - Country:US
Mailing Address - Phone:808-524-8344
Mailing Address - Fax:808-524-8437
Practice Address - Street 1:1520 LILIHA STREET
Practice Address - Street 2:SUITE 606
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96817-3564
Practice Address - Country:US
Practice Address - Phone:808-524-8344
Practice Address - Fax:808-524-8437
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIDT 15001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice