Provider Demographics
NPI:1861568396
Name:OGAWA, AMY A (DMD)
Entity type:Individual
Prefix:DR
First Name:AMY
Middle Name:A
Last Name:OGAWA
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:A
Other - Last Name:OGAWA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DMD INC
Mailing Address - Street 1:94 801 FARRINGTON HWY
Mailing Address - Street 2:STE 202
Mailing Address - City:WAIPAHU
Mailing Address - State:HI
Mailing Address - Zip Code:96797
Mailing Address - Country:US
Mailing Address - Phone:808-678-8999
Mailing Address - Fax:808-671-8883
Practice Address - Street 1:94 801 FARRINGTON HWY
Practice Address - Street 2:STE 202
Practice Address - City:WAIPAHU
Practice Address - State:HI
Practice Address - Zip Code:96797
Practice Address - Country:US
Practice Address - Phone:808-678-8999
Practice Address - Fax:808-671-8883
Is Sole Proprietor?:No
Enumeration Date:2006-11-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI1452122300000X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered122300000XDental ProvidersDentist
Not Answered1223G0001XDental ProvidersDentistGeneral Practice