Provider Demographics
NPI:1770612046
Name:KAWASHIMA, CHAD (DDS)
Entity type:Individual
Prefix:DR
First Name:CHAD
Middle Name:
Last Name:KAWASHIMA
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1255 NUUANU AVE # E-3107
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96817-4017
Mailing Address - Country:US
Mailing Address - Phone:808-533-3892
Mailing Address - Fax:808-523-1240
Practice Address - Street 1:1139 BETHEL ST
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-2219
Practice Address - Country:US
Practice Address - Phone:808-533-3892
Practice Address - Fax:808-523-1240
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIDT19611223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice