Provider Demographics
NPI:1821837113
Name:OAK, SOPHIA (DMD)
Entity type:Individual
Prefix:DR
First Name:SOPHIA
Middle Name:
Last Name:OAK
Suffix:
Gender:F
Credentials:DMD
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 401
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96814-2669
Mailing Address - Country:US
Mailing Address - Phone:808-230-9255
Mailing Address - Fax:
Practice Address - Street 1:1481 S KING ST STE 401
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-2669
Practice Address - Country:US
Practice Address - Phone:808-230-9255
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-24
Last Update Date:2024-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS044635122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist