Individual provider Active NPI

Gary Shigeru Yonemoto, D.D.S., M.S.

  • Endodontics
  • Honolulu, HI
National Provider Identifier
1356479703
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
1010 Issued in HI
Practice address
1100 Ward Ave
Suite 1015
Honolulu, HI 96814-1600
Phone
(808) 532-3900
Fax
(808) 532-3955
NPI assigned
Feb 28, 2007
Sex
Male
Sole proprietor
No

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
Endodontics 1223E0200X 1010 HI Primary

Addresses

Primary practice location

1100 Ward Ave
Suite 1015
Honolulu, HI 96814-1600

Mailing address

1100 Ward Ave
Suite 1015
Honolulu, HI 96814-1600
Phone (808) 532-3900

Other identifiers 2

IdentifierTypeStateIssuer
179562OtherHIUNITED CONCORDIA
A8820-1OtherHIHMSA

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
1010HIMDEndodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Endodontic Specialists, Inc. Endodontics Past Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1172620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1356479703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 WARD AVE",
            "address_2": "SUITE 1015",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968141600",
            "telephone_number": "808-532-3900",
            "fax_number": "808-532-3955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 WARD AVE",
            "address_2": "SUITE 1015",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968141600",
            "telephone_number": "808-532-3900",
            "fax_number": "808-532-3955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YONEMOTO",
        "first_name": "GARY",
        "middle_name": "SHIGERU",
        "name_prefix": "Dr.",
        "credential": "D.D.S., M.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "HI",
            "license": "1010",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "179562",
            "state": "HI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HMSA",
            "identifier": "A8820-1",
            "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.

Verify at the official NPI Registry.