Organization
TAKATA DENTAL HEALTH CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELLSWORTH H TAKATA JR. D.D.S. (PRESIDENT)
(808) 935-3351
Entity
Organization
Contact information
Practice address
445 WAIANUENUE AVE, HILO, HI 96720-2535
(808) 935-3351
Mailing address
445 WAIANUENUE AVE, HILO, HI 96720-2535
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
2068
HI
1223G0001X
General Practice Dentistry
Primary
991
HI
1223P0221X
Pediatric Dentistry
2102
HI
1223P0221X
Pediatric Dentistry
751
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
51866501
—
HI
Enumeration date
01/12/2007
Last updated
09/11/2025
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