Conrad C Theiss DMD Inc

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

DT0971 Issued in GU

Legal business name

CONRAD C THEISS DMD INC

Practice address

33 Lono Ave Suite 210
Kahului, HI 96732

Phone

(808) 877-3605

NPI assigned

Dec 8, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Conrad C Theiss

Title

Periodontist

Phone

(808) 877-3605

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Paul Kent Gibbons, DDS

  • General Practice Dentistry
  • Kahului, HI
  • NPI 1700096948
  NPD (past)

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

{
    "created_epoch": "1260230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1260230400000",
    "number": "1194054940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 LONO AVE STE 210",
            "city": "KAHULUI",
            "state": "HI",
            "postal_code": "967321632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 LONO AVE SUITE 210",
            "city": "KAHULUI",
            "state": "HI",
            "postal_code": "96732",
            "telephone_number": "808-877-3605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONRAD C THEISS DMD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-08",
        "last_updated": "2009-12-08",
        "status": "A",
        "authorized_official_last_name": "THEISS",
        "authorized_official_first_name": "CONRAD",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PERIODONTIST",
        "authorized_official_telephone_number": "808-877-3605",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Periodontics",
            "state": "GU",
            "license": "DT0971",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Natalie Colome
• Madeline Colon, LCSW
• Community Clinic of Maui, Inc.
• Peter L Conmy, D.D.S., M.S.
• Suni Marie Connelly, DC
• Lynette Constantino
• Ellecia Cook, D.O.
• Terrill Lee Coon, RBT
• Kristin Cordaro, RN
• Imelda A Cordero, CERTIFIED NURSE ASST

• Periodontics in Kahului, HI
• Providers in Kahului, HI by specialty
• Periodontics in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 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.

Verify at the official NPI Registry.