Organization Active NPI

Lyle T. Tenjoma DDS, MSD

  • Dentist
  • Ewa Beach, HI
National Provider Identifier
1083094601
Registry record updated Jun 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
1262 Issued in HI
Legal business name
LYLE T. TENJOMA DDS, MSD
Practice address
91-902 Fort Weaver Rd Ste 208
Ewa Beach, HI 96706-2261
Phone
(808) 689-7964
NPI assigned
Jun 9, 2015
Organization subpart
Yes
Parent organization
LYLE T. TENJOMA DDS, MSDAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 9, 2015

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

Authorized official

Name
Dr. Lyle T. Tenjoma, DDS, MSD
Title
Owner
Phone
(808) 941-4511

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 1262 HI Primary

Addresses

Primary practice location

91-902 Fort Weaver Rd Ste 208
Ewa Beach, HI 96706-2261

Mailing address

91-902 Fort Weaver Rd Ste 208
Ewa Beach, HI 96706-2261
Phone (808) 689-7964

National Provider Directory

National Provider Directory
Tax ID family
Lyle T Tenjoma DDS MSD2 organizations share this tax ID, including this one
Part of
Lyle T Tenjoma DDS MSD

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1433808000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1433808000000",
    "number": "1083094601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "91-902 FORT WEAVER RD STE 208",
            "city": "EWA BEACH",
            "state": "HI",
            "postal_code": "967062261",
            "telephone_number": "808-689-7964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "91-902 FORT WEAVER RD STE 208",
            "city": "EWA BEACH",
            "state": "HI",
            "postal_code": "967062261",
            "telephone_number": "808-689-7964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LYLE T. TENJOMA DDS, MSD",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LYLE T. TENJOMA DDS, MSD",
        "enumeration_date": "2015-06-09",
        "last_updated": "2015-06-09",
        "status": "A",
        "authorized_official_last_name": "TENJOMA",
        "authorized_official_first_name": "LYLE",
        "authorized_official_middle_name": "T.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "808-941-4511",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS, MSD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "HI",
            "license": "1262",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ewa Beach, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2015; 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.