Provider Demographics
NPI:1942449855
Name:HAROLD MASUNAGA DDS INC
Entity Type:Organization
Organization Name:HAROLD MASUNAGA DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROSS
Authorized Official - Middle Name:
Authorized Official - Last Name:MASUNAGA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:808-622-1116
Mailing Address - Street 1:960 CENTER ST STE 3
Mailing Address - Street 2:
Mailing Address - City:WAHIAWA
Mailing Address - State:HI
Mailing Address - Zip Code:96786-2038
Mailing Address - Country:US
Mailing Address - Phone:808-622-1116
Mailing Address - Fax:
Practice Address - Street 1:1600 KAPIOLANI BLVD STE 515
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-3802
Practice Address - Country:US
Practice Address - Phone:808-949-6705
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HAROLD MASUNAGA DDS INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-02-17
Last Update Date:2009-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI1897122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty