# MARK K. KOIZUMI, D.D.S., INC.

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1538373972
- **Authorized official:** DR. MARK K. KOIZUMI D.D.S. (PRESIDENT)
- **Authorized official phone:** (808) 935-1149

## Contact information

- **Practice address:** 275 PONAHAWAI ST, SUITE 103, HILO, HI 96720-3074
- **Practice address phone:** (808) 935-1149
- **Mailing address:** 275 PONAHAWAI ST, SUITE 103, HILO, HI 96720-3074
- **Mailing address phone:** (808) 935-1149

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | DT-1380 | HI | Yes |

## Other

- **Enumeration date:** 05/09/2007
- **Last updated:** 06/29/2012