Kevin R. Omuro, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

1453 Issued in HI

Practice address

3434 Old Haleakala Hwy
Makawao, HI 96768-8510

Phone

(808) 572-9111

NPI assigned

May 22, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in HI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Pukalani Dental Group, LLP

  • Dentist
  • Makawao, HI
  • NPI 1396019956
  NPD (past) Authorized official

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

{
    "created_epoch": "1179792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1330646400000",
    "number": "1407066400",
    "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": {
        "last_name": "OMURO",
        "first_name": "KEVIN",
        "middle_name": "R.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-22",
        "last_updated": "2012-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "HI",
            "license": "1453",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Milagros Noel, MS
• Nohoana Way of Life Inc
• Nova Luna
• Ohana Recovery
• Ohana-Hale Acupuncture, Inc.
• On the Path Counseling, LLC
• Optimal Physical Therapy,LLC
• Orthodontic Associates LLC
• Jessica Oshier, LPC
• Lula J Pacheco, LMT

• General Practice Dentistry in Makawao, HI
• Providers in Makawao, HI by specialty
• General Practice Dentistry in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2012; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.