Provider Demographics
NPI:1922180678
Name:MABE, ROY KAZUO (DDS)
Entity Type:Individual
Prefix:DR
First Name:ROY
Middle Name:KAZUO
Last Name:MABE
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 1:1600 KAPIOLANI BLVD
Mailing Address - Street 2:STE 515
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96814
Mailing Address - Country:US
Mailing Address - Phone:808-949-6705
Mailing Address - Fax:808-946-7185
Practice Address - Street 1:1600 KAPIOLANI BLVD
Practice Address - Street 2:STE 515
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814
Practice Address - Country:US
Practice Address - Phone:808-949-6705
Practice Address - Fax:808-946-7185
Is Sole Proprietor?:No
Enumeration Date:2006-10-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI06801223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice