Provider Demographics
NPI:1942501226
Name:HA, JOHN (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:
Last Name:HA
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 1:1481 S KING ST STE 303
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96814-2694
Mailing Address - Country:US
Mailing Address - Phone:808-941-2088
Mailing Address - Fax:808-947-2154
Practice Address - Street 1:1481 S KING ST STE 303
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-2694
Practice Address - Country:US
Practice Address - Phone:808-941-2088
Practice Address - Fax:808-947-2154
Is Sole Proprietor?:No
Enumeration Date:2010-11-03
Last Update Date:2016-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI2595122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist