Individual provider Active NPI

Keith A. Vodzak, D.M.D. M.S.D., ORTHO

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Honolulu, HI
National Provider Identifier
1104065085
Registry record updated Feb 17, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
DT-1666 Issued in HI
Practice address
377 Keahole St.
Suite #211
Honolulu, HI 96825
Phone
(808) 393-2020
NPI assigned
Feb 17, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X DT-1666 HI Primary

Addresses

Primary practice location

377 Keahole St.
Suite #211
Honolulu, HI 96825

Mailing address

42-125 Kooku Place
Kailua, HI 96734-5710
Phone (808) 393-2020

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

LicenseStateTypeSpecialty
DT-1666HIMDOrthodontics and Dentofacial Orthopedic Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
William Hu, DMD, Inc. Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1234828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1234828800000",
    "number": "1104065085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42-125 KOOKU PLACE",
            "city": "KAILUA",
            "state": "HI",
            "postal_code": "967345710",
            "telephone_number": "808-393-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "377 KEAHOLE ST.",
            "address_2": "SUITE #211",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "96825",
            "telephone_number": "808-393-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VODZAK",
        "first_name": "KEITH",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "D.M.D. M.S.D., ORTHO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-02-17",
        "last_updated": "2009-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "HI",
            "license": "DT-1666",
            "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 Feb 17, 2009; 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.