Rodney Nakano Nishimoto, DMD, MD

Primary specialty

Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X

License

DT-2883 Issued in HI

Practice address

900 Punahou St Ste 101
Honolulu, HI 96826-2500

Phone

(808) 949-8681

Fax

(808) 949-2488

NPI assigned

Mar 11, 2015

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Aug 14, 2021 through Aug 14, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Rodney N. Nishimoto, DMD, MD, LLC

  • Oral and Maxillofacial Surgery (Dentist)
  • Honolulu, HI
  • NPI 1225619505
  NPD Authorized official
• George a. Wessberg DDS, Inc

  • Oral and Maxillofacial Surgery (Dentist)
  • Honolulu, HI
  • NPI 1659544831
  NPD (past)

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

{
    "created_epoch": "1426032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633305600000",
    "number": "1386037570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 PUNAHOU ST STE 101",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968262500",
            "telephone_number": "808-949-8681",
            "fax_number": "808-949-2488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 PUNAHOU ST STE 101",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968262500",
            "telephone_number": "808-949-8681",
            "fax_number": "808-949-2488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NISHIMOTO",
        "first_name": "RODNEY",
        "middle_name": "NAKANO",
        "name_prefix": "Dr.",
        "credential": "DMD, MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-03-11",
        "last_updated": "2021-10-04",
        "certification_date": "2021-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "HI",
            "license": "MD-22040",
            "primary": false
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "HI",
            "license": "DT-2883",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Scott M Nishikawa, MD
• Michael Lewellyn Nishime, D.D.S.
• Kristyn Mieko Kitabayashi Nishimoto, MD
• Michael Nishimoto, PNP
• Patricia Winck Nishimoto, RN
• Stacie K. Nishimoto, M.D.
• Todd Mitsugi Nishimoto, M.D.
• Bryan Ichiro Nishimura, D.M.D.
• Chie Nishimura, APRN
• Earl K Nishimura, MD

• Oral & Maxillofacial Surgery (D.M.D.) in Honolulu, HI
• Providers in Honolulu, HI by specialty
• Oral & Maxillofacial Surgery (D.M.D.) in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.