Provider Demographics
NPI:1942335575
Name:KUBOTA, CINDY S (DMD)
Entity Type:Individual
Prefix:DR
First Name:CINDY
Middle Name:S
Last Name:KUBOTA
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:812 LEHUA AVE STE D
Mailing Address - Street 2:
Mailing Address - City:PEARL CITY
Mailing Address - State:HI
Mailing Address - Zip Code:96782-3621
Mailing Address - Country:US
Mailing Address - Phone:808-455-1973
Mailing Address - Fax:808-455-3488
Practice Address - Street 1:812 LEHUA AVE STE D
Practice Address - Street 2:
Practice Address - City:PEARL CITY
Practice Address - State:HI
Practice Address - Zip Code:96782-3621
Practice Address - Country:US
Practice Address - Phone:808-455-1973
Practice Address - Fax:808-455-3488
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI18541223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice