Active NPI
Alexander Karl Deitch, DDS
- Endodontics
- Honolulu, HI
National Provider Identifier
1144209073
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endodontics
- License
- DE00009035
- Practice address
- 1 Jarrett White Road
PRDC, USA Dentac Hawaii Credentials Office
Honolulu, HI 96859-5000 - Phone
- (808) 433-1021
- NPI assigned
- Jan 10, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Endodontics | 1223E0200X | DE00009035 | WA | Primary |
| Endodontics | 1223E0200X | 40927 | CA |
Addresses
Primary practice location
1 Jarrett White Road
PRDC, USA Dentac Hawaii Credentials Office
Honolulu, HI 96859-5000
Mailing address
1 Jarrett White Road
PRDC, USA Dentac Hawaii Credentials Office
Honolulu, HI 96859-5000
Phone (808) 433-1021
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DE00009035 | WA | MD | Endodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1136851200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1248220800000",
"number": "1144209073",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 JARRETT WHITE ROAD",
"address_2": "PRDC, USA DENTAC HAWAII CREDENTIALS OFFICE",
"city": "HONOLULU",
"state": "HI",
"postal_code": "968595000",
"telephone_number": "808-433-1021"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 JARRETT WHITE ROAD",
"address_2": "PRDC, USA DENTAC HAWAII CREDENTIALS OFFICE",
"city": "HONOLULU",
"state": "HI",
"postal_code": "968595000",
"telephone_number": "808-433-1021"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEITCH",
"first_name": "ALEXANDER",
"middle_name": "KARL",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-10",
"last_updated": "2009-07-22",
"status": "A"
},
"taxonomies": [
{
"code": "1223E0200X",
"taxonomy_group": "",
"desc": "Dentist, Endodontics",
"state": "WA",
"license": "DE00009035",
"primary": true
},
{
"code": "1223E0200X",
"taxonomy_group": "",
"desc": "Dentist, Endodontics",
"state": "CA",
"license": "40927",
"primary": false
}
],
"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 Jul 22, 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.