Provider Demographics
NPI:1548305212
Name:NAKAMATSU, DARREN Y (DMD)
Entity type:Individual
Prefix:DR
First Name:DARREN
Middle Name:Y
Last Name:NAKAMATSU
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 1:1 AUHILI PL
Mailing Address - Street 2:
Mailing Address - City:WAHIAWA
Mailing Address - State:HI
Mailing Address - Zip Code:96786-1505
Mailing Address - Country:US
Mailing Address - Phone:808-621-6626
Mailing Address - Fax:
Practice Address - Street 1:1000 KAMEHAMEHA HWY
Practice Address - Street 2:STE 235
Practice Address - City:PEARL CITY
Practice Address - State:HI
Practice Address - Zip Code:96782-2881
Practice Address - Country:US
Practice Address - Phone:808-456-5953
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIDT16041223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice