Palm Tree LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

PALM TREE LLC

Doing business as

Dededo Dental Center

Practice address

144 Kayen Chando Ste 101
Dededo, GU 96929-4906

Phone

(671) 637-4867

NPI assigned

Aug 18, 2025

Last updated

Aug 18, 2025By 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

Mr. Elias Abulencia

Title

General Manager

Phone

(671) 788-1706

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Dededo Dental Center Doing business as

Tax ID family

Dededo Dental Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Palm Tree LLC

  • Dental Clinic/Center
  • Dededo, GU
  • NPI 1982559480
  NPD tax ID

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.

• Sangwook Han, DDS

  • General Practice Dentistry
  • Dededo, GU
  • NPI 1265105605
  NPD

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

{
    "created_epoch": "1755475200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1755475200000",
    "number": "1376420083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "144 KAYEN CHANDO STE 101",
            "city": "DEDEDO",
            "state": "GU",
            "postal_code": "969294906",
            "telephone_number": "671-637-4867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "144 KAYEN CHANDO STE 101",
            "city": "DEDEDO",
            "state": "GU",
            "postal_code": "969294906",
            "telephone_number": "671-637-4867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALM TREE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-08-18",
        "last_updated": "2025-08-18",
        "certification_date": "2025-08-16",
        "status": "A",
        "authorized_official_last_name": "ABULENCIA",
        "authorized_official_first_name": "ELIAS",
        "authorized_official_title_or_position": "GENERAL MANAGER",
        "authorized_official_telephone_number": "671-788-1706",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1184990905",
            "state": "GU"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dededo Dental Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Verrad Kwasi Owusu Nyame, MD
• Rhoda Gaba Orallo, MSW, LCSW
• Dawn Dee Ostberg, FNP-BC
• Pacific Eye Center
• Richard Paul J. Pajela, PT, DPT
• Palm Tree LLC
• Hope Marie Jacosalem Pangelinan, MSW
• Roen Geneel Manalo Pangilinan, PHARMD
• Paraoceana Behavioral Health Services
• Zane Park, DPT

• Dental Clinic/Center in Dededo, GU
• Providers in Dededo, GU by specialty
• Dental Clinic/Center in Guam

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2025; 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.