Randall P Jaurequi, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2009 Issued in HI

Practice address

4370 Kukui Grove St
Suite 211
Lihue, HI 96766-2001

Phone

(808) 245-8866

Fax

(808) 246-0698

NPI assigned

Dec 12, 2006

Last updated

Aug 1, 2014By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Hawaiian Island Dental, Inc.

  • General Practice Dentistry
  • Lihue, HI
  • NPI 1316278906
  NPD (past) Authorized official

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1406851200000",
    "number": "1275694655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4370 KUKUI GROVE ST",
            "address_2": "SUITE 211",
            "city": "LIHUE",
            "state": "HI",
            "postal_code": "967662001",
            "telephone_number": "808-245-8866",
            "fax_number": "808-246-0698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4370 KUKUI GROVE ST",
            "address_2": "SUITE 211",
            "city": "LIHUE",
            "state": "HI",
            "postal_code": "967662001",
            "telephone_number": "808-245-8866",
            "fax_number": "808-246-0698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAUREQUI",
        "first_name": "RANDALL",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-12",
        "last_updated": "2014-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "HI",
            "license": "2009",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "50514101",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tad Jackson, MD
• Bennett Jacoby
• Ashley Jean James, FNP-BC
• Janie H Yoo MD LLC (Kauai Eye Institute)
• Kalanikauleleiaiwi Ah Len Jardine, RBT
• Martha Jay, LCSW
• Jeffreypearscounselingllc
• Matthew D Jenkins, APRN-RX, PMHNP-BC
• Sarah Elizabeth Jenkins
• Beth Rees Jensen, RBT

• General Practice Dentistry in Lihue, HI
• Providers in Lihue, HI by specialty
• General Practice Dentistry in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2014; 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.