Provider Demographics
NPI:1801805346
Name:OKANO, MICHAEL M (DDS)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:M
Last Name:OKANO
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 1:1001 KAMOKILA BOULEVARD
Mailing Address - Street 2:JC BUILDING 102
Mailing Address - City:KAPOLEI
Mailing Address - State:HI
Mailing Address - Zip Code:96707
Mailing Address - Country:US
Mailing Address - Phone:808-674-9299
Mailing Address - Fax:808-674-9280
Practice Address - Street 1:1001 KAMOKILA BOULEVARD
Practice Address - Street 2:JC BUILDING 102
Practice Address - City:KAPOLEI
Practice Address - State:HI
Practice Address - Zip Code:96707
Practice Address - Country:US
Practice Address - Phone:808-674-9299
Practice Address - Fax:808-674-9280
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIDT1558122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist