Provider Demographics
NPI:1902799927
Name:RUSSELL K TASAKA, DMD, LLC
Entity type:Organization
Organization Name:RUSSELL K TASAKA, DMD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:RUSSELL
Authorized Official - Middle Name:K
Authorized Official - Last Name:TASAKA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-949-2025
Mailing Address - Street 1:1600 KAPIOLANI BLVD STE 1425
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96814-3805
Mailing Address - Country:US
Mailing Address - Phone:808-949-2025
Mailing Address - Fax:
Practice Address - Street 1:1600 KAPIOLANI BLVD STE 1425
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-3805
Practice Address - Country:US
Practice Address - Phone:808-949-2025
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-29
Last Update Date:2025-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty