Provider Demographics
NPI:1669538914
Name:BERT M. SUMIKAWA, D.D.S., INC.
Entity type:Organization
Organization Name:BERT M. SUMIKAWA, D.D.S., INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PREIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BERT
Authorized Official - Middle Name:MASAYOSHI
Authorized Official - Last Name:SUMIKAWA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:808-593-8828
Mailing Address - Street 1:1026 S KING ST
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96814-2114
Mailing Address - Country:US
Mailing Address - Phone:808-593-8828
Mailing Address - Fax:808-596-0248
Practice Address - Street 1:1026 S KING ST
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-2114
Practice Address - Country:US
Practice Address - Phone:808-593-8828
Practice Address - Fax:808-596-0248
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI7161223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty