Hawaii Elite Oms LLC

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

Legal business name

HAWAII ELITE OMS LLC

Practice address

930 Valkenburgh St SPC 206
Honolulu, HI 96818-3914

Phone

(808) 342-5920

NPI assigned

Jul 2, 2025

Last updated

Jul 2, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Katie Tunder

Title

Billing Manager

Phone

(877) 667-7669

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in HI

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Harry J. Jackson, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Honolulu, HI
  • NPI 1376505578
  Medicare reassignment NPD
• James Masataka Michino, D.M.D.

  • Oral and Maxillofacial Surgery (Dentist)
  • Honolulu, HI
  • NPI 1730494931
  Medicare reassignment NPD

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

{
    "created_epoch": "1751414400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1751414400000",
    "number": "1114816105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "930 VALKENBURGH ST SPC 206",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968183914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "930 VALKENBURGH ST SPC 206",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968183914",
            "telephone_number": "808-342-5920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAWAII ELITE OMS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-07-02",
        "last_updated": "2025-07-02",
        "certification_date": "2025-07-02",
        "status": "A",
        "authorized_official_last_name": "TUNDER",
        "authorized_official_first_name": "KATIE",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "877-667-7669"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Hawaii Eye Clinic, Inc.

• Oral and Maxillofacial Surgery (Dentist) in Honolulu, HI
• Providers in Honolulu, HI by specialty
• Oral and Maxillofacial Surgery (Dentist) in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.