# OAHU ORAL AND MAXILLOFACIAL SURGERY

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** OAHU ORAL & MAXILLOFACIAL SURGERY
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1952941817
- **Legal business name:** OAHU ORAL & MAXILLOFACIAL SURGERY
- **Authorized official:** HEIDI MARTIN (CREDENTIALING AND CONTRACTING)
- **Authorized official phone:** (808) 230-8000

## Contact information

- **Practice address:** 1441 KAPIOLANI BLVD STE 920, HONOLULU, HI 96814-4405
- **Practice address phone:** (808) 973-3700
- **Practice address fax:** (808) 973-3707
- **Mailing address:** 45-1144 KAMEHAMEHA HWY STE 301, KANEOHE, HI 96744-3226
- **Mailing address phone:** (808) 230-8000
- **Mailing address fax:** (808) 369-8292

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | NULL | Yes |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | — | Yes |

## Other

- **Enumeration date:** 01/08/2020
- **Last updated:** 01/08/2020