Individual
DR. MARK YUJI SHIMAO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
91-902 FORT WEAVER RD STE 201, EWA BEACH, HI 96706-2261
(808) 689-6900
(808) 689-8330
Mailing address
91-902 FORT WEAVER RD STE 201, EWA BEACH, HI 96706-2261
(808) 689-6900
(808) 689-8330
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
1694
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1694
STATE LIC. ID #
HI
01
—
721292
UNITED CONCORDIA ID #
HI
01
—
81694
HDS ID #
HI
01
—
K9063-5
HMSA ID #
HI
Enumeration date
03/28/2007
Last updated
07/08/2007
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