Provider Demographics
NPI:1831424589
Name:DAVID M IWASAKI DDS INC
Entity type:Organization
Organization Name:DAVID M IWASAKI DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:MASAJI
Authorized Official - Last Name:IWASAKI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:808-247-5373
Mailing Address - Street 1:45-880 KAMEHAMEHA HWY STE 102
Mailing Address - Street 2:
Mailing Address - City:KANEOHE
Mailing Address - State:HI
Mailing Address - Zip Code:96744-2969
Mailing Address - Country:US
Mailing Address - Phone:808-247-5373
Mailing Address - Fax:808-235-6671
Practice Address - Street 1:45-880 KAMEHAMEHA HWY
Practice Address - Street 2:STE. 102
Practice Address - City:KANEOHE
Practice Address - State:HI
Practice Address - Zip Code:96744-2969
Practice Address - Country:US
Practice Address - Phone:808-247-5373
Practice Address - Fax:808-235-6671
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
HIDT- 16011223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty