Individual
JASON KAOPUA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
16-192 PILI MUA ST, KEAAU FAMILY HEALTH CENTER, KEAAU, HI 96749
(808) 930-0400
(808) 934-3238
Mailing address
311 KALANIANAOLE AVE, BAY CLINIC INC, HILO, HI 96720
(808) 930-0419
(808) 961-5167
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DT2042
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
252240
—
HI
01
—
824916
UHA
HI
01
—
D217358
HMSA
HI
Enumeration date
04/11/2006
Last updated
12/06/2011
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