Individual provider Active NPI

Trevor Donald Hartwell, D.D.S.

  • Dentist
  • Kamuela, HI
National Provider Identifier
1154559268
Registry record updated Aug 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DT2432 Issued in HI
Practice address
64-5191 Kinohou St
Kamuela, HI 96743-7392
Phone
(808) 443-2636
Fax
(808) 769-5023
NPI assigned
Jun 26, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 30, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DT2432 HI Primary

Addresses

Primary practice location

64-5191 Kinohou St
Kamuela, HI 96743-7392

Mailing address

64-5191 Kinohou St
Kamuela, HI 96743-7392
Phone (808) 443-2636

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150730013022 HI Order and Referring Only - DentistPractitioner - Dentist 6002120318

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DT2432HIMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Trevor Hartwell DDS LLC CurrentSince Jan 1, 2016 Accepting new patients

Locations

64-5191 Kinohou St
Ste C
Kamuela, HI 96743

64-5191 Kinohou St
Kamuela, HI 96743
Phone (808) 885-7144

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": "1245974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693353600000",
    "number": "1154559268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "64-5191 KINOHOU ST",
            "city": "KAMUELA",
            "state": "HI",
            "postal_code": "967437392",
            "telephone_number": "808-443-2636",
            "fax_number": "808-769-5023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "64-5191 KINOHOU ST",
            "city": "KAMUELA",
            "state": "HI",
            "postal_code": "967437392",
            "telephone_number": "808-443-2636",
            "fax_number": "808-769-5023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARTWELL",
        "first_name": "TREVOR",
        "middle_name": "DONALD",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-06-26",
        "last_updated": "2023-08-30",
        "certification_date": "2023-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "HI",
            "license": "DT2432",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kamuela, HI

Sources for this page

Verify at the official NPI Registry.