Individual provider Active NPI

Matthew Takashi Oda, DMD

  • General Practice Dentistry
  • Ewa Beach, HI
National Provider Identifier
1366093197
Registry record updated Sep 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DT-2834 Issued in HI
Practice address
91-791 Papipi Rd RM 1
Ewa Beach, HI 96706-2456
Phone
(808) 689-7966
Fax
(808) 689-0966
NPI assigned
Sep 23, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DT-2834 HI Primary

Addresses

Primary practice location

91-791 Papipi Rd RM 1
Ewa Beach, HI 96706-2456

Mailing address

91-791 Papipi Rd RM 1
Ewa Beach, HI 96706-2456
Phone (808) 689-7966

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

LicenseStateTypeSpecialty
DT-2834HIMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Gary T Oda DDS General Practice CurrentSince Jan 21, 2024 Accepting new patients

Locations

91-791 Papipi Rd
Rm 1
Ewa Beach, HI 96706
Phone (808) 689-7966

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": "1569196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569196800000",
    "number": "1366093197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "91-791 PAPIPI RD RM 1",
            "city": "EWA BEACH",
            "state": "HI",
            "postal_code": "967062456",
            "telephone_number": "808-689-7966",
            "fax_number": "808-689-0966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "91-791 PAPIPI RD RM 1",
            "city": "EWA BEACH",
            "state": "HI",
            "postal_code": "967062456",
            "telephone_number": "808-689-7966",
            "fax_number": "808-689-0966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ODA",
        "first_name": "MATTHEW",
        "middle_name": "TAKASHI",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-09-23",
        "last_updated": "2019-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "HI",
            "license": "DT-2834",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ewa Beach, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2019; 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.