Elite Smile Center, LLC

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

DT-1904 Issued in HI

Legal business name

ELITE SMILE CENTER, LLC

Practice address

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

Phone

(808) 329-4425

Fax

(808) 329-0872

NPI assigned

Dec 28, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Won Chaekal, DDS

Title

Owner

Phone

(808) 329-4425

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1356652800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1374624000000",
    "number": "1104162858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "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"
        },
        {
            "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": "ELITE SMILE CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-28",
        "last_updated": "2013-07-24",
        "status": "A",
        "authorized_official_last_name": "CHAEKAL",
        "authorized_official_first_name": "WON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "808-329-4425",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "HI",
            "license": "DT-1904",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "HI",
            "license": "DT-1904",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Orthodontics and Dentofacial Orthopedics Dentistry in Kailua Kona, HI
• Providers in Kailua Kona, HI by specialty
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2013; 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.