Provider Demographics
NPI:1821215443
Name:OAK'S DENTAL CLINIC
Entity Type:Organization
Organization Name:OAK'S DENTAL CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SUNNAM
Authorized Official - Middle Name:
Authorized Official - Last Name:OAK
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:808-946-2875
Mailing Address - Street 1:1481 S KING ST STE 401
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96814-2669
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1481 S KING ST STE 401
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-2669
Practice Address - Country:US
Practice Address - Phone:808-946-2875
Practice Address - Fax:808-955-9709
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI1768261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental