Provider Demographics
NPI:1952525818
Name:CHIN, WAYNE M (DMD)
Entity Type:Individual
Prefix:DR
First Name:WAYNE
Middle Name:M
Last Name:CHIN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1441 KAPIOLANI BLVD
Mailing Address - Street 2:SUITE 1019
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96814-4402
Mailing Address - Country:US
Mailing Address - Phone:808-946-1200
Mailing Address - Fax:808-941-4948
Practice Address - Street 1:1441 KAPIOLANI BLVD
Practice Address - Street 2:SUITE 1019
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-4402
Practice Address - Country:US
Practice Address - Phone:808-946-1200
Practice Address - Fax:808-941-4948
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI11541223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIA414OtherHMSA PROVIDER #
HI1154OtherHAWAII DENTAL LICENSE #
HI1154OtherHDS PROVIDER #