Organization Active NPI

Hualalai Dental Services

  • Dentist
  • Kailua Kona, HI
National Provider Identifier
1083656359
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
HUALALAI DENTAL SERVICES
Practice address
75-1028 Henry St
Suite 203
Kailua Kona, HI 96740-1693
Phone
(808) 329-4425
Fax
(808) 329-0872
NPI assigned
Jun 12, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Leighton Thomas Miller, DDS
Title
PC Holder
Phone
(209) 476-4700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

75-1028 Henry St
Suite 203
Kailua Kona, HI 96740-1693

Mailing address

555 W Benjamin Holt Dr
Building B
Stockton, CA 95207-3839
Phone (309) 476-4700

Other names 1

  • Gentle Dental (Kona) Doing business as

National Provider Directory

National Provider Directory

Locations

555 W Benjamin Holt Dr
Bldg B
Stockton, CA 95207
Phone (209) 476-4700

NPI Registry JSON

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

{
    "created_epoch": "1150070400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1083656359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 W BENJAMIN HOLT DR",
            "address_2": "BUILDING B",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952073839",
            "telephone_number": "309-476-4700",
            "fax_number": "209-478-6430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75-1028 HENRY ST",
            "address_2": "SUITE 203",
            "city": "KAILUA KONA",
            "state": "HI",
            "postal_code": "967401693",
            "telephone_number": "808-329-4425",
            "fax_number": "808-329-0872"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HUALALAI DENTAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "LEIGHTON",
        "authorized_official_middle_name": "THOMAS",
        "authorized_official_title_or_position": "PC HOLDER",
        "authorized_official_telephone_number": "209-476-4700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gentle Dental (Kona)",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Kailua Kona, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.