Provider Demographics
NPI:1144364803
Name:INOUYE, DWIGHT ISAMU (DDS)
Entity type:Individual
Prefix:
First Name:DWIGHT
Middle Name:ISAMU
Last Name:INOUYE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2153 N KING ST
Mailing Address - Street 2:#314
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96819-4559
Mailing Address - Country:US
Mailing Address - Phone:808-847-3702
Mailing Address - Fax:
Practice Address - Street 1:2153 N KING ST
Practice Address - Street 2:#314
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96819-4559
Practice Address - Country:US
Practice Address - Phone:808-847-3702
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI1063122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI06792401Medicaid
HI88369OtherHMSA
HI0106301OtherHOS
HI06792401Medicare ID - Type Unspecified