Provider Demographics
NPI:1740515303
Name:LESLIE K. OKIMOTO D.D.S., INC.
Entity type:Organization
Organization Name:LESLIE K. OKIMOTO D.D.S., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LESLIE
Authorized Official - Middle Name:K
Authorized Official - Last Name:OKIMOTO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:808-597-1322
Mailing Address - Street 1:1040 S KING ST STE 201
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96814-2117
Mailing Address - Country:US
Mailing Address - Phone:808-597-1322
Mailing Address - Fax:808-597-8932
Practice Address - Street 1:1040 S KING ST STE 201
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-2117
Practice Address - Country:US
Practice Address - Phone:808-597-1322
Practice Address - Fax:808-597-8932
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-14
Last Update Date:2009-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI18031223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty