NPIMap

Organization Active NPI

Hawaii Dental Group, Inc.

  • General Practice Dentistry
  • Hilo, HI
National Provider Identifier
1497063226
Registry record updated Sep 14, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
HAWAII DENTAL GROUP, INC.
Practice address
400 Hualani St
BLDG. 9, Suite 192
Hilo, HI 96720-4378
Phone
(808) 935-6620
Fax
(808) 935-6781
NPI assigned
Sep 14, 2010
Organization subpart
Yes
Parent organization
HAWAII DENTAL GROUP, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 14, 2010

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

Authorized official

Name
Dr. Gary Kondo
Title
Chief Executive Officer
Phone
(808) 523-3103

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
EndodonticsGroup: 193200000X MULTI-SPECIALTY GROUP 1223E0200X
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X Primary
Pediatric DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0221X
PeriodonticsGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0300X
ProsthodonticsGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0700X
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223X0400X
Dental HygienistGroup: 193200000X MULTI-SPECIALTY GROUP 124Q00000X
Dental AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 126800000X

Addresses

Primary practice location

400 Hualani St
BLDG. 9, Suite 192
Hilo, HI 96720-4378

Mailing address

500 Ala Moana Blvd
Suite 7-220
Honolulu, HI 96813-4920
Phone (808) 523-3103

Other names 1

  • Hawaii Family Dental Centers-Hilo Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Hawaii Dental Group Inc12 organizations share this tax ID, including this one
Part of
Hawaii Dental Group Inc

Other organizations with this tax ID 11

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

Locations

400 Hualani St
Ste 192
Hilo, HI 96720
Phone (808) 935-6620

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1284422400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1284422400000",
    "number": "1497063226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 ALA MOANA BLVD",
            "address_2": "SUITE 7-220",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968134920",
            "telephone_number": "808-523-3103",
            "fax_number": "808-523-3122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 HUALANI ST",
            "address_2": "BLDG. 9, SUITE 192",
            "city": "HILO",
            "state": "HI",
            "postal_code": "967204378",
            "telephone_number": "808-935-6620",
            "fax_number": "808-935-6781"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAWAII DENTAL GROUP, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HAWAII DENTAL GROUP, INC.",
        "enumeration_date": "2010-09-14",
        "last_updated": "2010-09-14",
        "status": "A",
        "authorized_official_last_name": "KONDO",
        "authorized_official_first_name": "GARY",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "808-523-3103",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Endodontics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Periodontics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Prosthodontics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "124Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dental Hygienist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "126800000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dental Assistant",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hawaii Family Dental Centers-Hilo",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hilo, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2010; 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.