Harrison Masao Ishida, D.D.S.

Individual provider Active NPI General Practice Dentistry · Honolulu, HI

NPI 1043228166 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1043228166
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
DT1497 (HI)
Practice address
3174 Waialae Ave
Honolulu, HI 96816-1510
Phone
(808) 734-7777
Fax
(808) 734-1406
NPI assigned
Aug 4, 2006
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
DT1497HIMDGeneral Practice Dentistry

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DT1497 HI Yes

Addresses

Primary practice location

3174 Waialae Ave
Honolulu, HI 96816-1510

Mailing address

3174 Waialae Ave
Honolulu, HI 96816-1510
Phone (808) 734-7777

Other identifiers

IdentifierTypeStateIssuer
DT1497OtherHISTATE LICENSE NUMBER

Other providers in Honolulu, HI

All providers in Honolulu, HI · General Practice Dentistry in Hawaii

Sources for this page

Verify at the official NPI Registry.