Provider Demographics
NPI:1023128857
Name:CLYDE G.C. MEW, D.D.S., M.SC.D., INC.
Entity type:Organization
Organization Name:CLYDE G.C. MEW, D.D.S., M.SC.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & PERIODONTOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CLYDE
Authorized Official - Middle Name:GC
Authorized Official - Last Name:MEW
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MSCD
Authorized Official - Phone:808-947-4222
Mailing Address - Street 1:2065 S KING ST
Mailing Address - Street 2:SUITE 209
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96826-2225
Mailing Address - Country:US
Mailing Address - Phone:808-947-4222
Mailing Address - Fax:
Practice Address - Street 1:2065 S KING ST
Practice Address - Street 2:SUITE 209
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96826-2225
Practice Address - Country:US
Practice Address - Phone:808-947-4222
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI942261Q00000X, 261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Not Answered261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI942OtherHAWAII DENTAL LICENSE #
HI8811-2OtherHMSA BLUECROSSBLUESHIELD
HI8811-2OtherHMSA BLUECROSSBLUESHIELD