Provider Demographics
NPI:1144921750
Name:GORADIA, KRISHNA
Entity type:Individual
Prefix:
First Name:KRISHNA
Middle Name:
Last Name:GORADIA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:848 S BERETANIA ST STE 304
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-2551
Mailing Address - Country:US
Mailing Address - Phone:808-531-5071
Mailing Address - Fax:808-536-1424
Practice Address - Street 1:848 S BERETANIA ST STE 304
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-2551
Practice Address - Country:US
Practice Address - Phone:808-531-5071
Practice Address - Fax:808-536-1424
Is Sole Proprietor?:No
Enumeration Date:2023-03-13
Last Update Date:2025-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIDT-30871223G0001X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice