NPIMap

Organization Active NPI

Cedric T Lewis, DMD, LLC

Doing business as Waialae Dental Care

  • General Practice Dentistry
  • Honolulu, HI
National Provider Identifier
1184709867
Registry record updated Aug 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DT1943 Issued in HI
Legal business name
CEDRIC T LEWIS, DMD, LLC
Doing business as
Waialae Dental Care
Practice address
4211 Waialae Ave
Suite 501
Honolulu, HI 96816-5306
Phone
(808) 732-4377
Fax
(808) 732-4158
NPI assigned
Oct 25, 2006
Last updated
Aug 4, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2008

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

Authorized official

Name
Dr. Cedric T Lewis, DMDNPI 1457582058
Title
Sole Member/Owner
Phone
(808) 732-4377

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DT1943 HI Primary

Addresses

Primary practice location

4211 Waialae Ave
Suite 501
Honolulu, HI 96816-5306

Mailing address

4211 Waialae Ave
Suite 501
Honolulu, HI 96816-5306
Phone (808) 732-4377

Other identifiers 4

IdentifierTypeStateIssuer
222778OtherHIHMSA
DT1943OtherHIDENTAL LICENSE
01460794OtherHITRICARE DENTAL PLAN
194302OtherHIHDS

Other names 1

  • Waialae Dental Care Doing business as

National Provider Directory

National Provider Directory

Locations

4211 Waialae Ave
Ste 501
Honolulu, HI 96816
Phone (808) 732-4377

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1217808000000",
    "number": "1184709867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4211 WAIALAE AVE",
            "address_2": "SUITE 501",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968165306",
            "telephone_number": "808-732-4377",
            "fax_number": "808-732-4158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4211 WAIALAE AVE",
            "address_2": "SUITE 501",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968165306",
            "telephone_number": "808-732-4377",
            "fax_number": "808-732-4158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CEDRIC T LEWIS, DMD, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-25",
        "last_updated": "2008-08-04",
        "status": "A",
        "authorized_official_last_name": "LEWIS",
        "authorized_official_first_name": "CEDRIC",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "SOLE MEMBER/OWNER",
        "authorized_official_telephone_number": "808-732-4377",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "HI",
            "license": "DT1943",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HMSA",
            "identifier": "222778",
            "state": "HI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTAL LICENSE",
            "identifier": "DT1943",
            "state": "HI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE DENTAL PLAN",
            "identifier": "01460794",
            "state": "HI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HDS",
            "identifier": "194302",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Waialae Dental Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Aug 4, 2008; 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.