NPIMap

Organization Active NPI

Dept. of Health-Hawaii-Developmental Disabilities Division Cmu1

  • Developmental Disabilities Clinic/Center
  • Honolulu, HI
National Provider Identifier
1306190301
Registry record updated Oct 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmental Disabilities Clinic/CenterTaxonomy code 261QD1600X
Legal business name
DEPT. OF HEALTH-HAWAII-DEVELOPMENTAL DISABILITIES DIVISION CMU1
Practice address
3627 Kilauea Ave
Room 411 DDD-Cmu 1
Honolulu, HI 96816-2317
Phone
(808) 587-6043
NPI assigned
Oct 30, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2012

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

Authorized official

Name
Dr. David Fray, D.D.S.
Title
Chief
Phone
(808) 586-5842

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Developmental Disabilities Clinic/Center 261QD1600X Primary

Addresses

Primary practice location

3627 Kilauea Ave
Room 411 DDD-Cmu 1
Honolulu, HI 96816-2317

Mailing address

1250 Punchbowl St
Room 463 Attn: Phao
Honolulu, HI 96813-2416
Phone (808) 587-6043

National Provider Directory

National Provider Directory
Tax ID family
Hawaii County Comm HLTH103 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

3627 Kilauea Ave
Rm 411
Honolulu, HI 96816
Phone (808) 587-6043

NPI Registry JSON

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

{
    "created_epoch": "1351555200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1351555200000",
    "number": "1306190301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1250 PUNCHBOWL ST",
            "address_2": "ROOM 463 ATTN: PHAO",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968132416",
            "telephone_number": "808-587-6043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3627 KILAUEA AVE",
            "address_2": "ROOM 411 DDD-CMU 1",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968162317",
            "telephone_number": "808-587-6043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEPT. OF HEALTH-HAWAII-DEVELOPMENTAL DISABILITIES DIVISION CMU1",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-30",
        "last_updated": "2012-10-30",
        "status": "A",
        "authorized_official_last_name": "FRAY",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "CHIEF",
        "authorized_official_telephone_number": "808-586-5842",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Oct 30, 2012; 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.