Active NPI
Family Dental Clinic, Inc.
- General Practice Dentistry
- Honolulu, HI
National Provider Identifier
1356492003
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- DT1882
- Legal business name
- FAMILY DENTAL CLINIC, INC.
- Practice address
- 1210 Dillingham Blvd
Suite 12
Honolulu, HI 96817-4436 - Phone
- (808) 847-1225
- Fax
- (808) 847-1226
- NPI assigned
- Jan 16, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Maria Pormento Adora, D.M.D.
- Title
- General Dentistry
- Phone
- (808) 847-1225
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DT1882 | HI | Primary |
Addresses
Primary practice location
1210 Dillingham Blvd
Suite 12
Honolulu, HI 96817-4436
Mailing address
1210 Dillingham Blvd
Suite 12
Honolulu, HI 96817-4436
Phone (808) 847-1225
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1882 | Other | HI | HDS |
| 859012 | Other | HI | UNITED CONCORDIA CO.,INC. |
| K0206603 | Other | HI | HMSA |
| 07806601 | Medicaid | HI |
National Provider Directory
National Provider DirectoryLocations
1210 Dillingham Blvd
Ste 12
Honolulu, HI 96817
Phone (808) 847-1225
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168905600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1356492003",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1210 DILLINGHAM BLVD",
"address_2": "SUITE 12",
"city": "HONOLULU",
"state": "HI",
"postal_code": "968174436",
"telephone_number": "808-847-1225",
"fax_number": "808-847-1226"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1210 DILLINGHAM BLVD",
"address_2": "SUITE 12",
"city": "HONOLULU",
"state": "HI",
"postal_code": "968174436",
"telephone_number": "808-847-1225",
"fax_number": "808-847-1226"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "FAMILY DENTAL CLINIC, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2007-01-16",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "ADORA",
"authorized_official_first_name": "MARIA",
"authorized_official_middle_name": "PORMENTO",
"authorized_official_title_or_position": "GENERAL DENTISTRY",
"authorized_official_telephone_number": "808-847-1225",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "D.M.D."
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Dentist, General Practice",
"state": "HI",
"license": "DT1882",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HDS",
"identifier": "1882",
"state": "HI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED CONCORDIA CO.,INC.",
"identifier": "859012",
"state": "HI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HMSA",
"identifier": "K0206603",
"state": "HI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "07806601",
"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 Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.