Active NPI
Lyle Y. Matsuo, DDS
- General Practice Dentistry
- Honolulu, HI
National Provider Identifier
1346357571
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- HI-1211
- Practice address
- 6700 Kalanianaole Hwy
Suite 202
Honolulu, HI 96825-1277 - Phone
- (808) 395-6577
- Fax
- (808) 395-6577
- NPI assigned
- Aug 24, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | HI-1211 | HI | Primary |
Addresses
Primary practice location
6700 Kalanianaole Hwy
Suite 202
Honolulu, HI 96825-1277
Mailing address
6700 Kalanianaole Hwy
Suite 202
Honolulu, HI 96825-1277
Phone (808) 395-6577
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| DT-1211 | Other | HI | DENTAL LICENSE NUMBER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| HI-1211 | HI | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156377600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1346357571",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6700 KALANIANAOLE HWY",
"address_2": "SUITE 202",
"city": "HONOLULU",
"state": "HI",
"postal_code": "968251277",
"telephone_number": "808-395-6577",
"fax_number": "808-395-6577"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6700 KALANIANAOLE HWY",
"address_2": "SUITE 202",
"city": "HONOLULU",
"state": "HI",
"postal_code": "968251277",
"telephone_number": "808-395-6577",
"fax_number": "808-395-6577"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATSUO",
"first_name": "LYLE",
"middle_name": "Y.",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-24",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "HI",
"license": "HI-1211",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DENTAL LICENSE NUMBER",
"identifier": "DT-1211",
"state": "HI"
}
],
"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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.