Individual provider Active NPI

Keith K. Yamakawa, D.D.S.

  • General Practice Dentistry
  • Hilo, HI
National Provider Identifier
1285852723
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DT1600 Issued in HI
Practice address
315 Kinoole St
Hilo, HI 96720-2918
Phone
(808) 969-3332
Fax
(808) 935-2899
NPI assigned
Apr 22, 2007
Sex
Male
Sole proprietor
Yes

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 DT1600 HI Primary

Addresses

Primary practice location

315 Kinoole St
Hilo, HI 96720-2918

Mailing address

315 Kinoole St
Hilo, HI 96720-2918
Phone (808) 969-3332

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
I20150813009538 HI Order and Referring Only - DentistPractitioner - Dentist 3870808306

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DT1600HIMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1177200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1285852723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 KINOOLE ST",
            "city": "HILO",
            "state": "HI",
            "postal_code": "967202918",
            "telephone_number": "808-969-3332",
            "fax_number": "808-935-2899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 KINOOLE ST",
            "city": "HILO",
            "state": "HI",
            "postal_code": "967202918",
            "telephone_number": "808-969-3332",
            "fax_number": "808-935-2899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YAMAKAWA",
        "first_name": "KEITH",
        "middle_name": "K.",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "HI",
            "license": "DT1600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hilo, HI

Sources for this page

Verify at the official NPI Registry.