Waikoloa Dental Clinic Inc

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DT 1606 Issued in HI

Legal business name

WAIKOLOA DENTAL CLINIC INC

Practice address

69-201 Waikoloa Beach Dr Ste 2615
Waikoloa, HI 96738-5815

Phone

(808) 886-0891

Fax

(808) 886-0892

NPI assigned

May 27, 2014

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Craig G Fostvedt, DDSNPI 1336213719

Title

Dentist/Owner

Phone

(808) 886-0891

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Craig G Fostvedt, DDS

  • General Practice Dentistry
  • Waikoloa, HI
  • NPI 1336213719
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1401148800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1401148800000",
    "number": "1003228982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "69-201 WAIKOLOA BEACH DRIVE # 2615",
            "city": "WAIKOLOA",
            "state": "HI",
            "postal_code": "96738",
            "telephone_number": "808-886-0891",
            "fax_number": "808-886-0892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "69-201 WAIKOLOA BEACH DR STE 2615",
            "city": "WAIKOLOA",
            "state": "HI",
            "postal_code": "967385815",
            "telephone_number": "808-886-0891",
            "fax_number": "808-886-0892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAIKOLOA DENTAL CLINIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-27",
        "last_updated": "2014-05-27",
        "status": "A",
        "authorized_official_last_name": "FOSTVEDT",
        "authorized_official_first_name": "CRAIG",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "DENTIST/OWNER",
        "authorized_official_telephone_number": "808-886-0891",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "HI",
            "license": "DT 1606",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Ann Kuualoha Terminello, PSY.D.
• Therapeutic Connection
• Melissa Lane Thompson, M.D.
• Anela Rachel Ubilas, LMT
• Visionemetz Optometry LLC
• Martin Scott Wallace, LMT
• West Hawaii Community Health Center, Inc.
• Women of the Rainbow

• General Practice Dentistry in Waikoloa, HI
• Providers in Waikoloa, HI by specialty
• General Practice Dentistry in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.