Active NPI
Edmund Anthony Cassella, DMD
- Periodontics
- Honolulu, HI
National Provider Identifier
1063567113
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- 1748
- Practice address
- 1441 Kapiolani Boulevard
Suite 1506
Honolulu, HI 96814-4407 - Phone
- (808) 955-1506
- NPI assigned
- Jan 25, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Periodontics | 1223P0300X | 1748 | HI | Primary |
Addresses
Primary practice location
1441 Kapiolani Boulevard
Suite 1506
Honolulu, HI 96814-4407
Mailing address
1441 Kapiolani Boulevard
Suite 1506
Honolulu, HI 96814-4407
Phone (808) 955-1506
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 |
|---|---|---|---|
| 1748 | HI | MD | Periodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169683200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1063567113",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1441 KAPIOLANI BOULEVARD",
"address_2": "SUITE 1506",
"city": "HONOLULU",
"state": "HI",
"postal_code": "968144407",
"telephone_number": "808-955-1506"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1441 KAPIOLANI BOULEVARD",
"address_2": "SUITE 1506",
"city": "HONOLULU",
"state": "HI",
"postal_code": "968144407",
"telephone_number": "808-955-1506"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CASSELLA",
"first_name": "EDMUND",
"middle_name": "ANTHONY",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-25",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "HI",
"license": "1748",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Honolulu, HI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.