Provider Demographics
NPI:1386793164
Name:WALSH, JAMES ROSS
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:ROSS
Last Name:WALSH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:JAMES
Other - Middle Name:
Other - Last Name:WALSH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:735 BISHOP ST
Mailing Address - Street 2:STE. #333
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-4817
Mailing Address - Country:US
Mailing Address - Phone:808-524-0444
Mailing Address - Fax:808-524-0456
Practice Address - Street 1:735 BISHOP ST
Practice Address - Street 2:STE. #333
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-4817
Practice Address - Country:US
Practice Address - Phone:808-524-0444
Practice Address - Fax:808-524-0456
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI14081223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice