NPIMap

Organization Active NPI

Pukalani Dental Group, LLP

  • Dentist
  • Makawao, HI
National Provider Identifier
1396019956
Registry record updated Feb 29, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
1453 Issued in HI
Legal business name
PUKALANI DENTAL GROUP, LLP
Practice address
3434 Old Haleakala Hwy
Makawao, HI 96768-8510
Phone
(808) 572-9111
NPI assigned
Feb 29, 2012
Last updated
Feb 29, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 29, 2012

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

Authorized official

Name
Dr. Kevin Omuro, DMDNPI 1407066400
Title
Dentist
Phone
(808) 572-9111

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)CodeLicenseStatePrimary
Dentist 122300000X 1453 HI Primary

Addresses

Primary practice location

3434 Old Haleakala Hwy
Makawao, HI 96768-8510

Mailing address

3434 Old Haleakala Hwy
Makawao, HI 96768-8510
Phone (808) 572-9111

National Provider Directory

National Provider Directory

Locations

3434 Old Haleakala Hwy
Makawao, HI 96768
Phone (808) 572-0822

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1330473600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1330473600000",
    "number": "1396019956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3434 OLD HALEAKALA HWY",
            "city": "MAKAWAO",
            "state": "HI",
            "postal_code": "967688510",
            "telephone_number": "808-572-9111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3434 OLD HALEAKALA HWY",
            "city": "MAKAWAO",
            "state": "HI",
            "postal_code": "967688510",
            "telephone_number": "808-572-9111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PUKALANI DENTAL GROUP, LLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-29",
        "last_updated": "2012-02-29",
        "status": "A",
        "authorized_official_last_name": "OMURO",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "808-572-9111",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "HI",
            "license": "1453",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Makawao, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 29, 2012; 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.