Provider Demographics
NPI:1912253808
Name:SCOTT T. NAKAHARA, D.D.S.
Entity Type:Organization
Organization Name:SCOTT T. NAKAHARA, D.D.S.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:T
Authorized Official - Last Name:NAKAHARA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:808-775-7294
Mailing Address - Street 1:45-3290 OHIA ST
Mailing Address - Street 2:
Mailing Address - City:HONOKAA
Mailing Address - State:HI
Mailing Address - Zip Code:96727-6935
Mailing Address - Country:US
Mailing Address - Phone:808-775-7294
Mailing Address - Fax:
Practice Address - Street 1:45-3290 OHIA ST
Practice Address - Street 2:
Practice Address - City:HONOKAA
Practice Address - State:HI
Practice Address - Zip Code:96727-6935
Practice Address - Country:US
Practice Address - Phone:808-775-7294
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-27
Last Update Date:2012-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIDT-12641223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty