Dawson Dermatology, LLC

Primary specialty

SpecialistTaxonomy code 174400000X

License

MD12990 Issued in HI

Legal business name

DAWSON DERMATOLOGY, LLC

Practice address

1380 Lusitana St
Suite 412
Honolulu, HI 96813-2421

Phone

(808) 599-3780

Fax

(808) 538-1672

NPI assigned

Dec 8, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Kevin L Dawson, M.D.NPI 1811959414

Title

Owner/Sole Member

Phone

(808) 599-3780

Specialties & licenses 2

Addresses

Other identifiers 4

Other names 1

• Dawson Dermatology Doing business as

Medicare fee-for-service enrollment

Enrolled in HI

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 7

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

• Kevin L Dawson, MD

  • Dermatology Physician
  • Honolulu, HI
  • NPI 1811959414
  Medicare reassignment Care Compare group NPD Authorized official
• Aaron Fong, MD

  • Dermatology Physician
  • Honolulu, HI
  • NPI 1316478720
  Medicare reassignment Care Compare group NPD
• Erin Nicole Fuller, MD

  • Dermatology Physician
  • Honolulu, HI
  • NPI 1730475633
  Medicare reassignment Care Compare group NPD
• Sarah Grekin, M.D.

  • Dermatology Physician
  • Honolulu, HI
  • NPI 1326205006
  Medicare reassignment Care Compare group NPD
• Douglas W. Chun, MD

  • Dermatology Physician
  • Honolulu, HI
  • NPI 1942373865
  Medicare reassignment NPD
• Rachel Inouye, PA-C

  • Physician Assistant
  • Honolulu, HI
  • NPI 1720750086
  Medicare reassignment
• Frederick Harada, M.D.

  • Specialist
  • Honolulu, HI
  • NPI 1144313875
  NPD (past)

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

{
    "created_epoch": "1165536000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1383782400000",
    "number": "1194885582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1380 LUSITANA ST",
            "address_2": "SUITE 412",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968132421",
            "telephone_number": "808-599-3780",
            "fax_number": "808-538-1672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1380 LUSITANA ST",
            "address_2": "SUITE 412",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968132421",
            "telephone_number": "808-599-3780",
            "fax_number": "808-538-1672"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAWSON DERMATOLOGY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-08",
        "last_updated": "2013-11-07",
        "status": "A",
        "authorized_official_last_name": "DAWSON",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER/SOLE MEMBER",
        "authorized_official_telephone_number": "808-599-3780",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "HI",
            "license": "MD1577",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "HI",
            "license": "MD12990",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA NUMBER",
            "identifier": "12D0620093",
            "state": "HI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HMSA PROV # - K DAWSON",
            "identifier": "00B0247375",
            "state": "HI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5533560",
            "state": "HI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HMSA PROV # - A IZUMI",
            "identifier": "00C0034110",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dawson Dermatology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Tiffany Davis
• Dawn Baxter, LLC
• Dawn Montgomery, PSYD, LLC
• Dawn Patrol Assessments
• Dawn Tawata LCSW LLC
• Adaure Ezinne Dawson, LM, CPM
• Daniel David Dawson, MD
• Jessica Anuenue Mailani Dawson, LMHC, LPC
• Kevin L Dawson, MD
• Lauren Kwon Dawson, PHD

• Specialist in Honolulu, HI
• Providers in Honolulu, HI by specialty
• Specialist in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.