Hawaiian Island Dental, Inc.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

HI2009 Issued in HI

Legal business name

HAWAIIAN ISLAND DENTAL, INC.

Practice address

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

Phone

(808) 245-8866

Fax

(808) 246-0698

NPI assigned

Jan 20, 2010

Last updated

Aug 1, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Randall P Jaurequi, DDSNPI 1275694655

Title

Owner

Phone

(808) 245-8866

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, and the practitioner matching its NPPES authorized official.

• Randall P Jaurequi, DDS

  • General Practice Dentistry
  • Lihue, HI
  • NPI 1275694655
  NPD (past) Authorized official

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

{
    "created_epoch": "1263945600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1406851200000",
    "number": "1316278906",
    "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": {
        "organization_name": "HAWAIIAN ISLAND DENTAL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-20",
        "last_updated": "2014-08-01",
        "status": "A",
        "authorized_official_last_name": "JAUREQUI",
        "authorized_official_first_name": "RANDALL",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "808-245-8866",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "HI",
            "license": "HI2009",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hawaii Life Flight, LLC
• Hawaii Mental Wellness, LLC
• Hawaii Pacific Dentalgroup
• Hawaii Smiles Designs LLC (Hawaii Smile Designs)
• Hawaii Sports and Balance Center
• Julie C Hayward, LCSW
• Hearing Sanctuary LLC
• Jessica Hedstrom
• Puanani J Hee, PHD
• Angela N Heiligenthal, PHD

• 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.