Provider Demographics
NPI:1861854143
Name:RADFORD Y. GOTO, DMD, LLC
Entity Type:Organization
Organization Name:RADFORD Y. GOTO, DMD, LLC
Other - Org Name:DIAMOND HEAD CHILDREN'S DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RADFORD
Authorized Official - Middle Name:YUTAKA
Authorized Official - Last Name:GOTO
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:808-791-1907
Mailing Address - Street 1:3150 MONSARRAT AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96815-4488
Mailing Address - Country:US
Mailing Address - Phone:808-791-1907
Mailing Address - Fax:808-743-4278
Practice Address - Street 1:3150 MONSARRAT AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96815-4488
Practice Address - Country:US
Practice Address - Phone:808-791-1907
Practice Address - Fax:808-743-4278
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-24
Last Update Date:2016-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIDT1977261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental