Individual provider Active NPI

Mendel Sato, DMD

  • General Practice Dentistry
  • Honolulu, HI
National Provider Identifier
1164558334
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
1117 Issued in HI
Practice address
3221 Waialae Ave
Ste. 315
Honolulu, HI 96816-5842
Phone
(808) 737-7905
NPI assigned
Feb 24, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 1117 HI Primary

Addresses

Primary practice location

3221 Waialae Ave
Ste. 315
Honolulu, HI 96816-5842

Mailing address

3221 Waialae Ave
Ste. 315
Honolulu, HI 96816-5842

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
I20150821014277 HI Order and Referring Only - DentistPractitioner - Dentist 9830404664

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1117HIMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Kaimuki Dental Group, L.L.P. 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": "1172275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1164558334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3221 WAIALAE AVE",
            "address_2": "STE. 315",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968165842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3221 WAIALAE AVE",
            "address_2": "STE. 315",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968165842",
            "telephone_number": "808-737-7905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SATO",
        "first_name": "MENDEL",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "HI",
            "license": "1117",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Honolulu, HI

Sources for this page

Verify at the official NPI Registry.