Mililani Dental Inc.

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

2481 Issued in HI

Legal business name

MILILANI DENTAL INC.

Practice address

95-1249 Meheula Parkway
138
Mililani, HI 96789

Phone

(808) 625-6223

NPI assigned

Aug 18, 2017

Organization subpart

No

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

Authorized official

Name

Dr. Bradford Matiasevich, DDSNPI 1720246473

Title

Owner/Dentist

Phone

(808) 366-1097

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 2

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

• Bradford David Matiasevich, D.D.S.

  • General Practice Dentistry
  • Freedom, CA
  • NPI 1720246473
  NPD (past) Authorized official
• Ernest Don Cheng, D.D.S.

  • General Practice Dentistry
  • Mililani, HI
  • NPI 1306855507
  NPD (past)

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

{
    "created_epoch": "1503014400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529107200000",
    "number": "1013433341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "95-1249 MEHEULA PKWY STE 138",
            "city": "MILILANI",
            "state": "HI",
            "postal_code": "967891788",
            "telephone_number": "808-625-6223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "95-1249 MEHEULA PARKWAY",
            "address_2": "138",
            "city": "MILILANI",
            "state": "HI",
            "postal_code": "96789",
            "telephone_number": "808-625-6223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MILILANI DENTAL INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-18",
        "last_updated": "2018-06-16",
        "status": "A",
        "authorized_official_last_name": "MATIASEVICH",
        "authorized_official_first_name": "BRADFORD",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "808-366-1097",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "HI",
            "license": "2481",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HMSA",
            "identifier": "0000316307",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Maile N. Miki, OD
• Mark Miki, PT, DPT
• Michael Orville Milcetich-Tano, LMFT
• Mililani Back Care Center, Inc.
• Mililani Dental Associates, LLC
• Mililani Dentists LLC
• Mililani Gastro, LLC
• Mililani Physical Therapy LLC
• Hailey Miller
• Melannie Miller, APRN

• Dental Clinic/Center in Mililani, HI
• Providers in Mililani, HI by specialty
• Dental Clinic/Center in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2018; 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.