Active NPI
Angela M Roldan-Whitaker, D.D.S.
- General Practice Dentistry
- Pearl Harbor, HI
National Provider Identifier
1043418676
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 55497
- Practice address
- Naval Health Clinic Hawaii
480 Central Ave
Pearl Harbor, HI 96860 - Phone
- (808) 474-3575
- Fax
- (808) 474-7806
- NPI assigned
- Jul 5, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 55497 | CA | Primary |
Addresses
Primary practice location
Naval Health Clinic Hawaii
480 Central Ave
Pearl Harbor, HI 96860
Mailing address
Naval Health Clinic Hawaii
480 Central Ave
Pearl Harbor, HI 96860
Phone (808) 474-3575
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 104348676 | Other | CA | MILITARY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 55497 | CA | MD | Surgical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1183593600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1719964800000",
"number": "1043418676",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "NAVAL HEALTH CLINIC HAWAII",
"address_2": "480 CENTRAL AVE",
"city": "PEARL HARBOR",
"state": "HI",
"postal_code": "96860",
"telephone_number": "808-474-3575",
"fax_number": "808-474-7806"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "NAVAL HEALTH CLINIC HAWAII",
"address_2": "480 CENTRAL AVE",
"city": "PEARL HARBOR",
"state": "HI",
"postal_code": "96860",
"telephone_number": "808-474-3575",
"fax_number": "808-474-7806"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROLDAN-WHITAKER",
"first_name": "ANGELA",
"middle_name": "M",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-07-05",
"last_updated": "2024-07-03",
"certification_date": "2024-06-26",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "55497",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MILITARY",
"identifier": "104348676",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Pearl Harbor, HI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.