Provider Demographics
NPI:1053744169
Name:KEVIN S SUGIKI DDS, LLC
Entity type:Organization
Organization Name:KEVIN S SUGIKI DDS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:SUGIKI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:808-735-8555
Mailing Address - Street 1:4211 WAIALAE AVE
Mailing Address - Street 2:SUITE 301
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96816-5319
Mailing Address - Country:US
Mailing Address - Phone:808-735-8555
Mailing Address - Fax:
Practice Address - Street 1:4211 WAIALAE AVE
Practice Address - Street 2:SUITE 301
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96816-5319
Practice Address - Country:US
Practice Address - Phone:808-735-8555
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-12
Last Update Date:2013-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI18061223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty